Claims Examiner – Auto, PIP, Litigation

🔥 20 hours ago

🏄 California, Minnesota, +1 more states – Remote

🏄 California – Remote ❄️ Minnesota – Remote 🤠 Texas – Remote

💵 $75k - $80k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

🦅 H1B Visa Sponsor

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Sedgwick

WebsiteLinkedInAll Job Openings

10,000+ employees

🏗️ Construction

💼 Consulting

🏥 Healthcare

Construction • Consulting • Healthcare

Sedgwick is a global provider of technology-enabled risk, benefits, and integrated business solutions. They help people and organizations by managing and mitigating risk with solutions in accident, health, disability, unemployment compensation, and liability claims administration, among others. Sedgwick offers services such as claims administration, building consulting, forensic accounting, and forensic engineering. Their specialties include property restoration, brand protection, and loss prevention across several industries, including agriculture, construction, and environmental sectors. The company emphasizes diversity, equity, and inclusion (DEI) as well as environmental, social, and governance (ESG) practices.

📋 Description

• Analyzes and processes complex or technically difficult third party property liability claims and personal injury protection 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. • 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 claims within designated authority level. • Prepares necessary state fillings within statutory limits. • Manages the litigation process; ensures timely and cost effective claims resolution. • 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. • Performs other duties as assigned.

🎯 Requirements

• Five (5) years of claims management experience or equivalent combination of education and experience required. • Bachelor's degree from an accredited college or university preferred. • Professional certification as applicable to line of business preferred. • excellent oral and written communication, including presentation skills • PC literate including Microsoft Office products • analytical and interpretive skills • excellent negotiation skills • ability to work in a team environment and meet or exceed Service Expectations

🏖️ Benefits

• medical, dental, vision • 401k and matching • PTO • disability and life insurance • employee assistance • flexible spending or health savings account • other additional voluntary benefits