Claims Examiner – Auto, General Liability, Bodily Injury

🔥 0 minutes ago

⚓ Rhode Island – Remote

⚓ Rhode Island – Remote

💵 $70k - $80k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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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 and manage complex or technically challenging general liability claims from inception through resolution • Conduct investigations to determine liability, damages, and claim exposure • Develop and execute strategic claim action plans • Assess liability and negotiate settlements within assigned authority limits • Calculate, establish, and maintain claim reserves • Authorize and process claim payments and adjustments within delegated authority • Ensure compliance with laws, regulations, and client-specific requirements • Prepare and submit required state filings within statutory deadlines • Report claims to excess carriers and respond to information or direction requests • Manage litigated claims in collaboration with defense counsel and external partners • Coordinate vendor referrals for investigations, medical reviews, surveillance, and litigation management • Use cost-containment strategies and vendor partnerships to reduce claim costs • Pursue and manage claim recoveries, including subrogation and applicable offsets • Communicate proactively with claimants, clients, attorneys, and stakeholders • Build and maintain client relationships through professional and responsive service • Accurately document and code claim files • Escalate complex issues and high-exposure matters to leadership • Perform other duties as assigned

🎯 Requirements

• Five (5) years of claims handling experience, or an equivalent combination of education and relevant experience • Experience handling complex general liability claims preferred • Litigation management experience strongly preferred • Bachelor's degree from an accredited college or university preferred • Industry certifications relevant to the line of business preferred • Strong knowledge of general liability claims practices, insurance principles, and applicable regulations • Understanding of recovery opportunities, subrogation, offsets, and cost containment strategies • Excellent verbal, written, and presentation communication skills • Strong analytical, investigative, and problem-solving abilities • Effective negotiation and settlement management skills • Ability to prioritize workload and manage multiple competing priorities • Ability to work independently and collaboratively within a team environment • Proficiency with Microsoft Office applications and claims management systems • Commitment to exceptional customer and client service • Computer keyboarding • Hearing, vision and talking • Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines • New Jersey claims handling knowledge/experience required by the role title

🏖️ Benefits

• Medical insurance • Dental insurance • Vision insurance • 401k and matching • PTO • Disability insurance • Life insurance • Employee assistance • Flexible spending or health savings account • Other additional voluntary benefits • Work-life balance • Flexible work arrangements implied by telecommuter location