Workers Compensation Auditor - California

📣 We’re Hiring: Workers Compensation Auditor - California

🌍 This is an exciting opportunity to join a global leader in claims management and make a meaningful impact through your expertise.

✅ Why Join Crawford & Company?
💻 Great Work From Home Opportunity
⭐ Generous Employee Referral Bonus Program
🛍️ Access to Multiple Employee Discounts

🔍 Role Overview:
Ensures that clients receive a quality work product by adhering to the established standards and addressing deficiencies in both technical and file content areas.

Responsibilities

• Evaluates, calculates, processes and logs penalties for all CA offices. Seeks clarification on information submitted and evaluates legal issues or defenses applicable. Requires evaluation of documentation, data, time lines, potential legal issues and defenses
• Pre-PAR and PAR auditing and preparation including ongoing auditing of claim files in preparation for the State's Division of WC audits
• Requires clear communication of findings and instructions for claims corrections, plus management of responses/disputes from claims staff
• Requires management of the process, tracking files involved and record keeping
• Requires follow up to assure completion and documentation is completed
• Coordinates, plans and confirms preparation of files for audit
• Processes and audits benefit payment data to identify potential payments off schedule, payments issued late, possible need for penalties
• Requires follow up and communication with claims staff throughout the state to assure completed on a regular schedule
• Response to WCIRB PD Surveys - requires review and research of the file, verifying calculations, completing applicable forms
• Response to claims handling questions
• Including questions on specific wage evaluation issues, questions about administration requirements, statutory or case law questions that affect administration, process questions, penalty questions, calculation questions
• Triage or takeover processes
• Program specific file reviews or assistance
• Upholds the Crawford Code of Conduct.

Qualifications

• High school diploma required. Bachelor's degree preferred
• Minimum 5 years experience with CA workers' compensation claims
• tensive adjusting experience, have CA Designations (equivalent of adjuster licensing), maintain CA adjuster CE requirements and capable of evaluating those requirements at a high level equivalent to what State auditors do in their audits. Capable of teaching, training, communicating and exerting direction on claims consistent with CA requirements.
• Must have a CA Experienced Claims Adjuster Designation per 10 CCR 2592 as well as documentation of maintaining Continuing Education requirements per that statute
• Must complete continuing education requirements as outlined by Crawford Educational Services

#LI-EM3 #LI-REMOTE

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. 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:

• Competitive base pay

- The Pay Range/Salary represents the anticipated low and high pay that may be offered for this position. To determine the actual offer, Crawford considers a wide range of factors including the candidate’s previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours. 

• 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. The core benefits* offered include:

- Medical, Dental and Vision Plans
- Prescription Drugs
- HSA, HRA, and FSA Accounts
- Paid Holidays, Vacation and Sick Leave
- 401(k) Retirement Plan
- Tuition Assistance
- Paid Parental Leave
- Supplemental Health Benefits

Other Benefits currently available at no cost include:

- Enhanced Mental Health Support
- Virtual Physical Therapy
- Caregiving Services
- Life Assistance Program

*The above information highlights some of the benefits currently available to eligible full-time employees.

• 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.