Claims Examiner jobs in Michigan

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.
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    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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Services Specialist 9-12 Houghton and Baraga County (Case Manager/ Investigator)
  • Medical Record Examiner E10
  • Houghton, MI FULL_TIME
  • Salary $49,795.20 - $81,931.20 Annually Location Houghton, MI Job Type Permanent Full Time Job Number SS - Houghton/Keweenaw/Baraga Department Health and Human Services - Counties Opening Date 01/30/2...
  • Just Posted

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Services Specialist 9-12 Presque Isle (Case Manager/ Investigator)
  • Medical Record Examiner
  • Rogers, MI FULL_TIME
  • Salary $49,795.20 - $81,931.20 Annually Location Rogers City, MI Job Type Permanent Full Time Job Number SS - Presque Isle Department Health and Human Services - Counties Opening Date 10/25/2023 Closi...
  • Just Posted

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MI - 1099 Property Claims Adjuster
  • Copper Claims Services, Inc.
  • Balitmore, MI FULL_TIME
  • 1099 Property Claims Adjuster Copper Claims Services is a quickly growing independent loss adjusting firm based out of Irvine, CA. Copper Claims Services excels in providing custom claims solutions fo...
  • 1 Month Ago

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Field Roof Inspector - Grand Rapids, MI
  • Hancock Claims Consultants Technicians
  • Grand Rapids, MI FULL_TIME
  • Hancock Claims Consultants specialize in Ladder Assist and Property Inspection Services, collaborating directly with numerous insurance agencies for efficient claims management. At Hancock, we are at ...
  • Just Posted

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Field Roof Inspector - Lansing, MI
  • Hancock Claims Consultants Technicians
  • Lansing, MI FULL_TIME
  • Hancock Claims Consultants specialize in Ladder Assist and Property Inspection Services, collaborating directly with numerous insurance agencies for efficient claims management. At Hancock, we are at ...
  • Just Posted

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Claims Examiner
  • MagnaCare
  • New York, NY
  • About The Role Brighton Health Plan Solutions (BHPS) is seeking an experienced Healthcare Claims Examiner skilled in the...
  • 4/25/2024 12:00:00 AM

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Claims Examiner
  • JCW
  • JCW is currently recruiting on behalf of a rapidly growing Property & Casualty Insurance Company who are looking to add ...
  • 4/23/2024 12:00:00 AM

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Claim Examiner
  • Kansas City Life Insurance Company
  • Kansas City, MO
  • QUALIFICATIONS/REQUIREMENTS: Bachelor of Arts or Sciences degree in business field, related field, or equivalent work ex...
  • 4/22/2024 12:00:00 AM

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Claims Examiner
  • The Jonus Group
  • Chicago, IL
  • We are seeking a Senior Claims Examiner to join our team. The Senior Claims Examiner will play a pivotal role in managin...
  • 4/22/2024 12:00:00 AM

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Claims Examiner
  • The Jonus Group
  • New York, NY
  • We are seeking a Senior Claims Examiner to join our team. The Senior Claims Examiner will play a pivotal role in managin...
  • 4/22/2024 12:00:00 AM

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Claims Examiner
  • The Jonus Group
  • Phoenix, AZ
  • We are seeking a Senior Claims Examiner to join our team. The Senior Claims Examiner will play a pivotal role in managin...
  • 4/22/2024 12:00:00 AM

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Claims Examiner
  • D3 Search
  • Mount Kisco, NY
  • D3 Search is actively seeking the following Claims Examiner II - Cyber candidate for a highly respected global insurer w...
  • 4/22/2024 12:00:00 AM

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Claims Examiner
  • The Jonus Group
  • White Plains, NY
  • We are seeking a Senior Claims Examiner to join our team. The Senior Claims Examiner will play a pivotal role in managin...
  • 4/22/2024 12:00:00 AM

Michigan consists of two peninsulas that lie between 82°30' to about 90°30' west longitude, and are separated by the Straits of Mackinac. The 45th parallel north runs through the state—marked by highway signs and the Polar-Equator Trail—along a line including Mission Point Light near Traverse City, the towns of Gaylord and Alpena in the Lower Peninsula and Menominee in the Upper Peninsula. With the exception of two small areas that are drained by the Mississippi River by way of the Wisconsin River in the Upper Peninsula and by way of the Kankakee-Illinois River in the Lower Peninsula, Michigan...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Examiner jobs
$47,241 to $62,644