Claims Examiner jobs in Detroit, MI

Claims Examiner reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Being a Claims Examiner studies reports prepared by adjusters and similar claims to determine the extent of insurance coverage and validity of the claim. Communicates with agents, claimants, and policy holders. Additionally, Claims Examiner determines settlement according to organization practices and procedures. May require a bachelor's degree. Typically reports to a supervisor or manager. The Claims Examiner work is closely managed. Works on projects/matters of limited complexity in a support role. To be a Claims Examiner typically requires 0-2 years of related experience. (Copyright 2024 Salary.com)

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Senior Claims Examiner - Workers Compensation
  • Crawford & Company
  • Livonia, MI OTHER
  • Excellence In Everything We Touch

    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 company 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.

     

    Requirements

    • Bachelor's degree or equivalent experience.
    • Technical claims investigations/settling experience with 4-8 years experience in Claims or similar organization.
    • Workers Compensation (WC) Adjuster License required according to jurisdictional requirements.
    • 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.
    •  

    Preferred:

    • Industry designations such as IIA, AIC, AEI and/or CPCU

    About Us

    Why Crawford?

     

    Because a claim is more than a number — it’s a person, a child, a friend. It’s anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community – one claim at a time.

     

    At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We’re looking for the next generation of leaders to take this journey with us.

     

    We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at www.crawco.com.

     

    When you accept a job with Crawford, you become a part of the One Crawford family. 

     

    • Our total compensation plans provide each of our employees with far more than just a great salary
    • 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

     

    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.

     

     

     

     

    #LI-EM3

  • 1 Month Ago

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Medical Biller
  • Provider Claims Mgmt.
  • Ortonville, MI PART_TIME,FULL_TIME
  • Company Overview: PCM is a leading fast-paced medical billing service committed to delivering high-quality care to our clients. We prioritize excellence in patient services and seek individuals who ar...
  • 5 Days Ago

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Front Desk Receptionist
  • Michigan Fire Claims
  • Auburn, MI FULL_TIME
  • Please read the entire post before applying; serious applicants only need apply. Michigan Fire Claims, Inc. has an immediate opening for our Front Desk Receptionist position. As “The Receptionist”, yo...
  • 18 Days Ago

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Public Adjuster
  • Michigan Fire Claims
  • Auburn, MI FULL_TIME
  • Michigan Fire Claims, Inc. is seeking a full-time licensed public adjuster for fire and water damage claims. We are a public adjusting company who specializes in representing the homeowner in the even...
  • 24 Days Ago

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Building Inspector/Plan Examiner
  • City of Rochester Hills
  • Rochester, MI FULL_TIME
  • The position performs building plan reviews and on-site field inspections of properties to verify compliance with the approved construction documents, adopted codes, and ordinances of the City, to saf...
  • 18 Days Ago

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Claims Admin
  • 166 Proctor
  • Troy, MI FULL_TIME
  • Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Job Title: Claims Admin FLSA Status: Non-Exempt Department: ...
  • 17 Days Ago

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0 Claims Examiner jobs found in Detroit, MI area

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Remote Insurance Agent
  • The Abbate Agency
  • Warren, MI
  • The Abbate Agency is seeking individuals looking to start a rewarding career in the insurance industry with room for gro...
  • 4/18/2024 12:00:00 AM

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Remote Insurance Agent
  • Propel Personnel
  • Detroit, MI
  • Job Description Job Description Remote Insurance Agent Job Overview Join one of the nation’s leading Fortune 100 Insuran...
  • 4/17/2024 12:00:00 AM

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Insurance Agent - Remote
  • Globe Life: AO Premier
  • Canton, MI
  • Coming off our record breaking year with over $114 Million in sales, we are looking for competitive, hard working indivi...
  • 4/17/2024 12:00:00 AM

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Insurance Agent - Remote
  • Globe Life: AO Premier
  • Ann Arbor, MI
  • Coming off our record breaking year with over $114 Million in sales, we are looking for competitive, hard working indivi...
  • 4/17/2024 12:00:00 AM

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Insurance Agent - Remote
  • AMG S Group
  • Detroit, MI
  • Job Description Job Description Join the National Agent Alliance, where we're not just about insurance – we're about sha...
  • 4/16/2024 12:00:00 AM

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Insurance Agent
  • Allied Insurance Managers Inc.
  • Rochester, MI
  • Description Are you a motivated people person looking for the chance to break into a new industry? If the answer is "yes...
  • 4/16/2024 12:00:00 AM

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Property & Casualty Insurance Agent
  • Gordon Group Insurance Agency
  • Livonia, MI
  • Job Description Job Description We are a local family-owned insurance agency celebrating our 45-year anniversary this fa...
  • 4/16/2024 12:00:00 AM

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Insurance Agent
  • MICHAEL LANTZY STATE FARM INSURANCE
  • Royal Oak, MI
  • Job Description Job Description Position Overview Are you outgoing and customer-focused? Do you enjoy working with the p...
  • 4/15/2024 12:00:00 AM

Detroit (/dɪˈtrɔɪt/, locally also /ˈdiːtrɔɪt/; French: Détroit, lit. 'strait') is the largest and most populous city in the U.S. state of Michigan, the largest United States city on the United States–Canada border, and the seat of Wayne County. The municipality of Detroit had a 2017 estimated population of 673,104, making it the 23rd-most populous city in the United States. The metropolitan area, known as Metro Detroit, is home to 4.3 million people, making it the second-largest in the Midwest after the Chicago metropolitan area. Regarded as a major cultural center, Detroit is known for its co...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Examiner jobs
$48,246 to $63,977
Detroit, Michigan area prices
were up 1.2% from a year ago