Claims Examiner, Auto – Bodily Injury

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🐊 Florida, North Carolina, +1 more states – Remote

🐊 Florida – Remote 🌲 North Carolina – Remote 🧀 Wisconsin – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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

• Analyze complex or technically difficult auto and general liability claims to determine benefits due • Work with high exposure claims involving litigation and rehabilitation • Ensure ongoing adjudication of claims within service expectations, industry best practices, and client service requirements • Identify subrogation of claims and negotiate settlements • Investigate and gather information to determine claim exposure • Manage claims through action plans to timely resolution • Assess liability and resolve claims within evaluation • Negotiate settlements within designated authority • Calculate and assign reserves and manage reserve adequacy • Calculate and pay benefits, approve claim payments and adjustments, and settle claims • Prepare necessary state filings within statutory limits • Manage the litigation process • Coordinate vendor referrals for investigation and litigation management • Use cost containment techniques and vendor partnerships • Manage claim recoveries, including subrogation, Second Injury Fund excess recoveries, and Social Security and Medicare offsets • Report claims to the excess carrier and respond to direction requests • Communicate claim activity with claimants and clients • Maintain professional client relationships • Ensure claim files are documented and claim coding is correct • Refer cases to supervisors and management as appropriate • Support the organization's quality programs • Perform other duties as assigned

🎯 Requirements

• Five (5) years of claims management experience or equivalent combination of education and experience required • In-depth knowledge of personal and commercial line auto policies, coverages, principles, and laws • Strong oral and written communication, including presentation skills • PC literate, including Microsoft Office products • Ability to work in a team environment • Secure and maintain the State adjusting licenses as required for the position • Computer keyboarding • Hearing, vision, and talking • Clear and conceptual thinking ability • Excellent judgment and discretion • Ability to meet deadlines

🏖️ Benefits

• Work-life balance • Caring culture • Equal Opportunity Employer • Drug-Free Workplace • Diverse, equitable, and inclusive workplace

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