Senior Claims Specialist, CA Workers Comp, Remote

Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry.

Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2025 Great Place to Work Award for our employee‑first focus and our steadfast commitment to diversity, equity and Inclusion.

C&F is part of Fairfax Financial Holdings, a global, billion dollar organization. For more information about Crum & Forster, please visit our website:

C&F’s Commercial Lines division delivers specialized insurance solutions for mid‑sized and large businesses across a broad range of commercial exposures, management liabilities, and industry segments.

Our portfolio includes tailored coverage solutions for General Liability, Commercial Auto, Workers’ Compensation, Property, and Excess Liability, as well as Financial Lines products such as Management Liability, Professional Liability, Cyber, Crime, and Fidelity.

With more than 700 employees across the United States, Commercial Lines combines deep underwriting expertise, disciplined risk selection, and the strength of C&F’s national platform. We work closely with our customers and distribution partners to provide responsive service, thoughtful risk solutions, and the confidence to navigate complex business challenges.

Examines claims data and conducts investigations into routine and moderately complex claims to determine coverage, compensability, subrogation and benefits under moderate supervisory direction. Adjusts and manages claims within the limit of assigned authority.

What you will do for C&F:

• Must be well versed in California Compensation statute claims.
• Receives lost time and complex medical only assignments. Verifies and determines applicability of coverage. Initiates 24‑hour contact with employer, employee and 48‑hour contact with attending physician.
• Handles catastrophic claims with supervisory oversight.
• Conducts telephone investigations as required by company claims handling manual and procedures.
• Evaluates and adjusts claims within the limits of authority.
• Consults with Claim Manager on those claims where assistance and consultation is needed.
• Makes assignments to nurse case management when indicated, monitoring their billing and performance.
• Sets reserves for anticipated exposure up to authority limits.
• Completes mandatory Reserve Worksheets. Establishes reserves requiring complex analysis with lifetime pharmacy and cost inflation.
• Coordinates return to work (RTW) and sets target dates.
• Maintain diaries on maximum three (3) month intervals.
• Documents files in the claims system.
• Reviews medical bills for causal relationship, medical bill charges for appropriateness and approves payments.
• Adheres to special account handling (SHI) instructions.
• Attends account meetings by telephone and in‑person.
• Manages litigation on the files.

What you will bring to C&F:

• Bachelor’s degree or equivalent experience.
• 3+ years of experience handling workers compensation claims.
• Strong organizational skills.
• Good time management skills.
• Foreign language communications a plus.
• Excellent verbal and written communication skills are essential.
• Strong aptitude and knowledge of Microsoft Office programs and the ability to quickly learn new programs.
• Will abide by departmental…