Location: Telecommuter
Company: Sedgwick Claims Management Services
support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve.
If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work. Great Place to Work Most Loved Workplace Forbes Best-in-State Employer Claims Examiner - Multi line, Casualty (REMOTE) Are
you looking for an impactful job where you can apply your knowledge and experience in the context of an energetic culture? Enjoy flexibility and autonomy in your daily work, your location, and your career path.
Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights. Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. ARE YOU AN IDEAL CANIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great
work. PRIMARY PURPOSE : To analyze investigate, evaluate and adjust auto liability, general liability and professional liability public entity claims.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES Analyzes and processes complex or technically difficult general and professional liability and auto liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. backsses liability and resolves claims within evaluation. Negotiates settlement of claims within designated authority. Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level. Prepares necessary state fillings within statutory limits. Manages the litigation process; ensures timely and cost effective claims resolution. Coordinates vendor referrals for additional investigation and/or litigation management. Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients. Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner. Communicates claim activity and processing with the claimant and the client; maintains professional client relationships. Ensures claim files are properly documented and claims coding is correct. Refers cases as appropriate to supervisor and management. ADDITIONAL FUNCTIONS and RESPONSIBILITIES Performs other duties as assigned. Supports the organization's quality program(s).
Travels as required. QUALIFICATION Education & Licensing Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Experience Five (5) years of claims management experience or equivalent combination of education and experience required. Skills & Knowledge Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
Excellent oral and written communication, including presentation skills PC literate, including Microsoft Office products Analytical and interpretive skills Strong organizational skills Good interpersonal skills Excellent negotiation skills Ability to work in a team environment Ability to meet or exceed Service Expectations WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Computer keyboarding, travel as required Auditory/Visual: Hearing, vision and talking NOTE : Credit security clearance, confirmed via a background credit check, is required for this position.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances.
Management retains the discretion to add or to change the duties of the position at any time. As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $ 80,000 USD/annual salary. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
#LI-REMOTE #LI-RS1 #claiminteractionaminer #claimsadjuster Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
You may be just the right candidate for this or other roles. Requisition #: R43755tcv57hlu2
Insurance jobs refer to career opportunities within the insurance industry, where professionals work to assess risks, provide financial protection to individuals and businesses, and offer various types of insurance coverage. Key features of these jobs include risk management, customer service, policy underwriting, claims handling, and potentially sales. Professionals in this field often require strong analytical skills, attention to detail, and excellent communication abilities to explain complex insurance products and assist clients with their insurance needs.
Insurance jobs refer to career opportunities within the insurance industry, where professionals work to assess risks, provide financial protection to individuals and businesses, and offer various types of insurance coverage. Key features of these jobs include risk management, customer service, policy underwriting, claims handling, and potentially sales. Professionals in this field often require strong analytical skills, attention to detail, and excellent communication abilities to explain complex insurance products and assist clients with their insurance needs.
Insurance jobs refer to careers within the insurance industry, where professionals help individuals and businesses manage risk and financial losses by providing them with insurance products. These roles can range from sales agents who sell policies, underwriters who assess risks and set premiums, claims adjustors who handle the compensation process, to actuaries who analyze statistical data to price insurance products accurately. The sector is known for its stability, opportunities for advancement, and the critical role it plays in personal financial planning and the economic health of society.
Insurance jobs encompass a variety of roles within the insurance industry, ranging from sales and customer service to risk assessment and claims processing. Professionals in this sector typically work for insurance companies, brokerages, or independent agencies, helping individuals and businesses understand and obtain coverage for potential risks. Key features of insurance jobs include analyzing financial risks, providing expert advice on insurance policies, handling policy renewals, and assisting clients with claims. This field requires strong interpersonal skills, attention to detail, and in some positions, analytical abilities to calculate and price insurance premiums. It's a sector known for its stability, opportunities for growth, and contribution to personal and economic security.