Temporary Liability Claims Adjuster I

Administers and resolves non-complex short term claims of low monetary amounts, including medical only claims. Documents and monitors open case inventory and ensures proper and timely closing of files. Makes decisions on claims within delegated limited authority. Conducts investigations of claims to confirm coverage and to determine liability, compensability, and damages. Works closely with claimants, witnesses and members of the medical profession and other persons pertinent to the investigation and processing of claims.
Verifies policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim.
Identifies wage loss expenses and wage exposures on medical claims.
Documents receipt and contents of medical reports. Interacts frequently with claimant to understand nature and extent of injury and medical conditions. Reviews and handles other correspondence within authority including material from the team members, and/or clients.
Approves payments of medical bills on lost time disability claims within area of payment authority up to, but not exceeding, $2,500 after compensability has been determined.
Evaluates medical claims for potential fraud issues, loss control and recovery in accordance with insurance policy contracts, medical bill coding rules and state regulations.
Keeps Team Manager informed verbally and in writing of activities and problems within assigned area of responsibility; Knowledge of claims and familiarity with claims terminology gained through industry experience and/or through specialized courses of study (Associate in Claim designation, etc).
Demonstrates a thorough working knowledge of claim processing and claim policies and procedures.
Demonstrates an understanding of basic medical terminology and appropriate medical tests for claimed conditions
Demonstrates a customer-focused approach including the ability to identify and understand customer needs, and interacts effectively with others.
Must have or secure and maintain the appropriate license(s) as required by the state(s) at the adjuster/supervisory/management level. Because a claim is more than a number - it’s a person, a child, a friend. And by helping to restore their lives, we are helping to restore our community - one claim at a time.
Our industry-leading team pioneers new solutions for the industries and customers we serve. We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. And as part of the One Crawford family, we offer a comprehensive Total Rewards package to our employees to assist with their financial, health/wellness, continuing education/training and other needs:

~ The Pay Range/Salary represents the anticipated low and high pay that may be offered for this position. Bonus/Incentive Pay and other Performance-Based Rewards, if applicable.
We offer a well-rounded benefits package that encourages wellness and helps our employees to be an educated healthcare consumer. Medical, Dental and Vision Plans

• HSA, HRA, and FSA Accounts
• Paid Holidays, Vacation and Sick Leave
• 401(k) Retirement Plan
• Virtual Physical Therapy
• Life Assistance Program *The above information highlights some of the benefits currently available to eligible full-time employees.