Crawford & Company · 21 hours ago
Claims Specialist-WC
United States
Full-time
Remote
New Grad, Entry LevelCrawford & Company is a global leader in claims management, dedicated to restoring lives and communities through effective claims processing. The Claims Specialist-WC role involves administering and resolving non-complex short-term claims, ensuring timely closure of files, and making decisions on claims within limited authority.
Insurance
Responsibilities
Conducts investigations of claims to confirm coverage and to determine liability, compensability, and damages. Works closely with claimants, witnesses and members of the medical profession and other persons pertinent to the investigation and processing of claims
Verifies policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim
Identifies wage loss expenses and wage exposures on medical claims
Documents receipt and contents of medical reports. Interacts frequently with claimant to understand nature and extent of injury and medical conditions. Reviews and handles other correspondence within authority including material from the team members, and/or clients
Approves payments of medical bills on lost time disability claims within area of payment authority up to, but not exceeding, $2,500 after compensability has been determined
Evaluates medical claims for potential fraud issues, loss control and recovery in accordance with insurance policy contracts, medical bill coding rules and state regulations
Keeps Team Manager informed verbally and in writing of activities and problems within assigned area of responsibility; refers matters beyond limits of authority and expertise to Team Manager for direction
With the team managers guidance, provides input on the completion of status reports, initiate's activity checks and/or widow's statement of dependency forms
Completes all reporting forms and file documentation
Adheres to client and carrier guidelines and prepares written updates for supervisor to review
Performs other related duties as required or requested
Qualification
Required
College degree or the equivalent of education and experience
Knowledge of claims and familiarity with claims terminology gained through industry experience and/or through specialized courses of study (Associate in Claim designation, etc)
Demonstrates a thorough working knowledge of claim processing and claim policies and procedures
Demonstrates an understanding of basic medical terminology and appropriate medical tests for claimed conditions
Demonstrates effective and diplomatic oral and written communication skills
Demonstrates a customer-focused approach including the ability to identify and understand customer needs, and interacts effectively with others
Must have or secure and maintain the appropriate license(s) as required by the state(s) at the adjuster/supervisory/management level
Must possess a valid driver's license
Must complete continuing education requirements as outlined by Crawford Educational Services
Additional courses may be required by jurisdiction for maintenance of license
Benefits
Pay and incentive plans that recognize performance excellence
Benefit programs that empower financial, physical, and mental wellness
Training programs that promote continuous learning and career progression while enhancing job performance
Sustainability programs that give back to the communities in which we live and work
A culture of respect, collaboration, entrepreneurial spirit and inclusion
Company
Crawford & Company
Based in Atlanta, GA Crawford & Company(R) (www.crawco.com) is the world's largest publicly listed independent provider of claims management and outsourcing solutions to carriers, brokers and corporates, with an expansive global network serving clients in more than 70 countries.
Founded in 1941
10001+ employees
H1B Sponsorship
Crawford & Company has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (1)
2024 (2)
2023 (7)
2022 (5)
2021 (2)
2020 (10)
Funding
Current Stage
Late StageLeadership Team
Larry Thomas
EVP - CEO Crawford U.S. Services
Bruce Swain
EVP - Chief Financial Officer
Recent News
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