Crum & Forster
Crum & Forster
1 001 – 5 000 Қызметкерлер
Медициналық сақтандыруСақтандыру
Crum & Forster — қабылданған және артық желілер сақтандырушылары арқылы арнайы және стандартты коммерциялық бағыттарда қызмет көрсететін АҚШ-тың мүлік пен жазатайым оқиғалардан сақтандыру компаниясы. Компанияның қызметі коммерциялық тәуекелге, талаптарды реттеуге және тәуекелдерді инженерлік бағалауға бағытталған сақтандыру өнімдері мен қызметтерін қамтитын әртараптандырылған арнайы сақтандыру платформасынан тұрады. 1822 жылы құрылған компания 2023 жылы 5,3 миллиард АҚШ доллары көлемінде жазылған сыйлықақы туралы есеп берді және A.M. Best қаржылық тұрақтылық рейтингінде A (Өте жақсы) бағасын иеленді. Crum & Forster АҚШ бойынша 2 000-нан астам адамды жұмыспен қамтып, мүлік пен жазатайым оқиғалардан сақтандыру және қайта сақтандыру салаларында жұмыс істейтін Fairfax Financial Holdings Limited тобының құрамына кіреді.

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.

Сипаттама

  • 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

Талаптар

  • 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

Артықшылықтар

  • 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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