Benefits Adjuster - Accident and Health Affinity
Under general supervision, evaluates and settles casualty claims of modest to complex exposure (including fatalities) by investigating losses, interpreting coverage, negotiating settlements and reporting obtained information in a timely and efficient manner, while maintaining adequate production levels.
- Examines claims forms, policies and endorsements, client instructions and other records to determine coverages.
- Investigates claims by interviewing insureds, claimants and witnesses, obtaining official reports, and by comparing claim information with evidence.
- Sets loss reserves.
- Prepares reports by collecting and summarizing information required by client, local, state and federal government and by Crawford.
- Settles claims by determining client’s coverages, liability, client’s instructions and authority levels required by obtaining demands and making offers to claimants, issuing settlement checks, making filings with regulatory agencies, disposing of salvage, pursuing subrogation when appropriate.
- Controlling claim costs.
- Recommends litigation when appropriate.
- Presents evidence at legal proceedings; producing reports and other documents as evidence.
- Maintains expected case load.
- Maintains company reputation and integrity of insurance products by complying with federal and state regulations and service standards.
- Maintain acceptable product quality through compliance with service standards and compliance with internal quality control initiatives.
- Maintains professional and technical knowledge through continuing education.
- May assist junior adjusters.
- Participates in special projects or performs duties in other areas as requested.
- Upholds the Crawford Code of Conduct.
- College degree or equivalent combination of education and experience.
- Minimum 6 months previous experience as a Claims Adjuster.
- Crawford provides 24-hours-a-day, 7-days-a-week service. A variable schedule including on-call may be required.
- Depending on case load you may be required to work beyond normal business hours when necessary.
- Must complete continuing education requirements as outlined by Crawford Educational Services.
- Must be licensed as required by state and local jurisdictions.
- Ability to handle multiple tasks.
- Strong interpersonal skills.
- Highly organized and self-directed.
- Flexible and able to change plans quickly.
- Good problem solver.
Think all TPAs are the same? Think again. With Broadspire, our leading global third-party administrator (TPA), Crawford & Company is the consultative outsourcing partner that adapts to businesses’ needs and challenges at any point of the claims processing journey. We offer casualty claim and medical management services to assist large organizations in achieving their unique goals, increasing employee productivity and reducing the cost of risk through professional expertise, technology and data analytics.
As part of the One Crawford family, Broadspire brings together the best and brightest people in the industry to deliver smart, thoughtful solutions to our clients, and we are guided by our collective value system: RESTORE.
At Crawford, we:
- Respect our culture of integrity and ethical behavior, while embracing the unique talents of the individual and encouraging an ownership mentality among everyone.
- Are Empowered to advance the company mission and take ownership of our individual career progression.
- Promote Sustainability through a corporate culture in which employees are good stewards of their communities.
- Emphasize Training and an environment where employees continually seek and share knowledge and are engaged and satisfied with their work.
- Are One Crawford, embracing a global mindset that’s inclusive, agile, mission-focused, and customer-focused.
- Give Recognition, participating in an environment where people are rewarded for jobs well done.
- Embody an Entrepreneurial Spirit, sharing a passion to succeed, innovate, and outpace our competitors.
We believe in leading by example – at work and in our communities. 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 mission, vision and values. Learn more at www.crawfordandcompany.com.
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.