Claims Examiner, Sr. jobs in Detroit, MI

Claims Examiner, Sr. reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Being a Claims Examiner, Sr. 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, Sr. determines settlement according to organization practices and procedures. May require a bachelor's degree. Typically reports to a supervisor or manager. The Claims Examiner, Sr. occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. To be a Claims Examiner, Sr. typically requires 2 -4 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...
  • 6 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...
  • 19 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...
  • 25 Days Ago

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Waitress/Waiter/ Hostess
  • CAMPBELL, JON M SR.
  • Garden, MI FULL_TIME
  • The Guest Experience Leader is an important role that will help bring a new guest experience to McDonald's. You will lead in delivering on the McDonald's brand promise of "Making Delicious Feel Food M...
  • 2 Days Ago

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Supervisor
  • CAMPBELL, JON M SR.
  • Garden, MI FULL_TIME
  • The Area Supervisor will have the ability to lead a patch of restaurants, oversee P&L statements and budgeting combined with strong people motivating and training skills. Follow up on HR related items...
  • 2 Days Ago

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0 Claims Examiner, Sr. jobs found in Detroit, MI area

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Claims Specialist
  • Calculated Hire
  • Detroit, MI
  • Subrogation Specialist Hybrid/Remote Depending on Location Full-Time $52k+/year Our client is seeking qualified Subrogat...
  • 4/19/2024 12:00:00 AM

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Claims Adjuster - Auto Estimator
  • Progressive Corp.
  • Sterling Heights, MI
  • Job Description - Claims Adjuster - Auto Estimator (188412) **** Claims Adjuster - Auto Estimator **Job Number** : 18841...
  • 4/19/2024 12:00:00 AM

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Senior Property Claims Representative
  • Michigan Farm Bureau
  • Rochester, MI
  • Senior Property Claims Representative US-MI-Rochester Job ID: 2024-4458 Type: Regular Full-Time # of Openings: 1 Categor...
  • 4/19/2024 12:00:00 AM

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Litigation Paralegal
  • Secrest Wardle
  • Troy, MI
  • Job Description Job Description Secrest Wardle’s Troy office is searching for a full-time defense litigation paralegal w...
  • 4/19/2024 12:00:00 AM

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Field Claims Representative
  • Auto-Owners Insurance
  • Northville, MI
  • A career at Auto-Owners is challenging and rewarding. Our group of caring associates create financial security by helpin...
  • 4/18/2024 12:00:00 AM

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Licensed Personal Lines Insurance Agent
  • Allied Insurance Managers Inc.
  • Rochester, MI
  • Description Are you a savvy sales professional who excels in building relationships and communicating with others? We're...
  • 4/17/2024 12:00:00 AM

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Safety Manager
  • KLA Laboratories
  • Dearborn, MI
  • Job Description Job Description Safety Coordinator Classification: Exempt Reports to: Director of HR Our Mission For alm...
  • 4/17/2024 12:00:00 AM

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Structural Engineer
  • Robson Forensic
  • Dearborn, MI
  • Job Description Job Description Structural Engineer Do you want to use your training, education, and experience in a new...
  • 4/16/2024 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, Sr. jobs
$62,792 to $80,956
Detroit, Michigan area prices
were up 1.2% from a year ago

Claims Examiner, Sr. in Riverside, CA
Health Claims Examiners, or Health Information Technicians, enter data electronically to process transactions.
December 14, 2019
Claims Examiner, Sr. in Evansville, IN
If you’re in dire straits, we can advise you on steps to get the OWCP claims examiner to pay attention to your needs, such as contacting the Department of Labor’s district director, or the national director via mail.
February 12, 2020
Claims Examiner, Sr. in Springfield, IL
No, the examiner is only involved in performing the exam and providing the results to the claims processor.
January 13, 2020