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Claim Examiner-WC (CA)

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POST DATE 9/9/2016
END DATE 11/11/2016

Broadspire Fresno, CA

Fresno, CA
AJE Ref #
Job Classification
Full Time
Job Type
Company Ref #
Mid-Career (2 - 15 years)
Bachelors Degree


Position Summary:

Investigate and settle advanced, large loss, complex claims promptly and equitably under minimal supervision. Works within established authority on moderate-to-difficult claims. Reviews coverages, determines liability and compensability, secures information, arranges property damage appraisals and settles claims utilizing claims best practices. Evaluates and sets reserves using independent judgment. Assists supervisor and defense attorneys in preparing cases for litigations. Conducts training and mentors new hires. Responsibilities:

* Interprets and makes decisions using independent judgment on more complex and unusual policy coverages and determines if coverages apply to claims submitted.

* Manages all aspects of investigative activity on complex claims. Directs the discovery and litigation strategy with legal counsel.

* Analyzes claims activity and prepares reports for clients/carriers and management.

* Establish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost effective manner and ensuring timely issuance of disbursements.

* Settles claims promptly and equitably and issues company drafts in payments for claims within authority limits.

* Develops subrogation and third party recovery potential and follows reclaim procedures.

* Analyzes claims activities and prepares reports for clients, carriers and/or management. Participates in claim reviews.


* Bachelor s degree or equivalent experience required.

* Technical claims investigations/settling experience with 5-10 years experience in Claims or similar organization.

* Workers Compensation (WC) Adjuster License required according to jurisdictional requirements

* California Certified Adjuster Designation and Post Designation, or a California Self-Insurer\'s Certificate

* Ability to work independently while assimilating various technical subjects..

* Strong written and oral communication, negotiation and presentation skills.

* Advanced analytical and problem solving skills, with the ability to manage and prioritize multiple projects.

* Effective advanced interpersonal skills to effectively interact with all levels of internal and external clients.


* Industry Designations preferred but not required (IIA, AIC, AEI, and/or CPCU).

* Bilingual English/Spanish a plus but not required.

In addition to a competitive salary, Crawford offers you:

* Career advancement potential locally, nationally and internationally. Crawford & Company has more than 700 locations in 70 countries;

* On-going training opportunities through every stage of your career;

* Strong benefits package including matching 401k; health, dental, and life insurance; employee stock purchase plans; tuition reimbursement and so much more.

Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V

Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.