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Crawford & Company · 1 day ago

Claims Specialist-WC

United States

Full-time

Remote

New Grad, Entry Level

Crawford & 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

H1B Sponsor Likely

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

Claims knowledgeClaim processingMedical terminologyEffective communicationCustomer-focused approachCollege degreeAdjuster license

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

Glassdoor3.6

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

Peachtree Corners, Georgia, US

10001+ employees

https://www.crawco.com

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)