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Crum & Forster
Crum & Forster
1,001 – 5,000 Employees
Healthcare InsuranceInsurance
Crum & Forster is a U.S. property and casualty insurance company offering specialty and standard commercial lines through admitted and surplus lines insurers. Its business spans a diversified specialty platform, including insurance products and services focused on commercial risk, claims, and risk engineering. Established in 1822, the company reported $5.3 billion in written premiums in 2023 and holds an A.M. Best financial strength rating of A (Excellent). Crum & Forster employs more than 2,000 people across the United States and is part of Fairfax Financial Holdings Limited, a group engaged in property and casualty insurance and reinsurance.
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Senior California Workers’ Compensation Claims Specialist

Handle California workers’ compensation claims for Crum & Forster’s commercial insurance portfolio. Investigate coverage, set reserves, coordinate return to work, and manage litigation.

USUnited StatesCACalifornia
$58,700 – $110,200 / year
RemoteFull-timeSeniorEnglish RequiredClaims Specialist

Description

  • Investigate routine and moderately complex claims using claims data
  • Determine coverage, compensability, subrogation, and benefits
  • Adjust and manage claims within assigned authority limits
  • Handle lost-time and complex medical-only assignments
  • Verify coverage and determine whether it applies
  • Contact employers and employees within 24 hours and attending physicians within 48 hours
  • Handle catastrophic claims under supervisory oversight
  • Conduct telephone investigations in line with claims handling procedures
  • Consult the Claim Manager when support is needed
  • Arrange nurse case management when indicated and monitor billing and performance
  • Set reserves for anticipated exposure within assigned authority limits
  • Complete required Reserve Worksheets and set reserves involving complex analysis
  • Coordinate return-to-work plans and establish target dates
  • Keep claim diaries updated at intervals of no more than three months
  • Record claim activity in the claims system
  • Review medical bills for causal connection and appropriateness, and approve payments
  • Follow special account handling instructions
  • Attend account meetings by phone and in person
  • Manage litigation on assigned claim files

Requirements

  • Bachelor’s degree or equivalent experience
  • At least three years of experience handling workers’ compensation claims
  • Strong working knowledge of California workers’ compensation statutes
  • Strong organizational ability
  • Effective time management
  • Excellent spoken and written communication
  • Strong aptitude for and knowledge of Microsoft Office applications
  • Ability to learn new programs quickly
  • Follow departmental policies and procedures, including authority limits, to meet risk management controls
  • Foreign language communication skills are an advantage

Benefits

  • Competitive compensation package
  • Employer 401(k) match
  • Employee stock purchase plan with employer matching
  • Generous paid time off
  • Health, dental, and vision coverage
  • Programs supporting physical, mental, and financial wellbeing
  • Tuition reimbursement
  • Industry-related certifications
  • Professional training
  • Dynamic, ambitious, and engaging work environment
  • Matching donation program
  • Volunteer opportunities
  • Employee-led corporate giving program
  • Equal employment opportunity and accommodations for applicants with disabilities

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