Analyze reported lower - level general liability claims for Sedgwick. Ensure ongoing adjudication of claims within company standards and industry best practices while working in a hybrid schedule.
About the role
- Claims Specialist at CNA managing complex workers compensation claims with high customer interaction. Ensuring compliance with insurance laws while delivering exceptional customer service.
Responsibilities
- Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.
- Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners.
- Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language.
- Conducts focused investigation to determine compensability, liability and covered damages.
- Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts.
- Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim.
- Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences.
Requirements
- Bachelor's Degree or equivalent experience.
- Typically a minimum four years of relevant experience, preferably in claim handling.
- Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience.
- Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.
- Professional designations are a plus (e.g. CPCU).
- Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.
- Demonstrated ability to develop collaborative business relationships with internal and external work partners.
- Demonstrated investigative experience with an analytical mindset and critical thinking skills.
- Strong work ethic, with demonstrated time management and organizational skills.
Benefits
- CNA offers a comprehensive and competitive benefits package to help our employees – and their family members – achieve their physical, financial, emotional and social wellbeing goals.
Job title
Job type
Experience level
Salary
Degree requirement
Location requirements
Claims Examiner for Sedgwick adjudicating complex workers' compensation claims within service expectations. Join a company recognized for its caring culture and work - life balance.
Claims Representative using claims systems to manage diary and handle auto claims. Conducting investigations, confirming coverage, and negotiating settlements with various stakeholders.
Senior Workers' Compensation Claims Adjuster handling loss time claims across jurisdictions. Working primarily in California and managing investigations and litigation.
Claims Adjuster managing and processing claims related to windshield repair and replacement. Interacting with customers and coordinating with repair facilities for efficient claims handling.
Medical Claims Examiner processing healthcare claims for Imagenet. Ensuring compliance and accuracy in claims adjudication and processing.
Claims Examiner adjudicating complex workers' compensation claims at Sedgwick. Analyzing claims, negotiating settlements, and managing resolutions for clients in various industries.
Field Claims Specialist inspecting large and complex property claims for Intact, providing customer service and conducting investigations on - site. Collaborating with various teams and adhering to company standards.
Claims intern role at Auto - Owners Insurance investigating policy coverage and assessing loss amounts. Assisting claims resolution and ensuring accurate payments while studying insurance policies.
Claims Specialist providing exceptional service managing complex medical stop loss claims at QBE. Collaborating with stakeholders and maintaining client relationships while ensuring compliance and strategy implementation.