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
- Senior Claims Examiner adjudicating complex commercial general liability claims at Hiscox. Providing operational support and ensuring compliance within a hybrid workplace environment.
Responsibilities
- The Senior Claims Examiner adjudicates assigned claims within given authority and provides operational support to the claims team.
- Adjusts and resolves moderate to complex claims that includes all phases of litigation
- Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities
- With minimal supervision, drafts coverage letters, including reservation of rights and denial letters
- Reviews and analyses claim documentation and legal filings to set timely and accurate a reserves and notify the manager if upward segmentation is needed
- Identifies emerging exposures and claims trends
- Drives litigation best practices to manage deployment and utilization of defense counsel
- Identifies suspected fraudulent claims and tracks with special investigations unit
- Participates in Claims Projects as needed
Requirements
- 3-5 years of claims handling experience in the area of commercial general liability with an insurance carrier
- Advanced knowledge of claims analysis and adjusting practices
- In depth knowledge of standards for claims documentation and legal filings
- Proven ability to actively and effectively negotiate settlement of moderate to complex claims
- Experience in mentoring and training other claims examiners
- Advanced analytical skills
- Strong verbal and written communication skills
- Active insurance adjuster’s license
- B.A./B.S degree from an accredited College or University preferred
Benefits
- 401(k) with competitive company matching
- Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care)
- Company paid group term life, short- term disability and long-term disability coverage
- 24 Paid time off days plus 2 Hiscox days,10 paid holidays plus 1 paid floating holiday, and ability to purchase up to 5 PTO days
- Paid parental leave
- 4-week paid sabbatical after every 5 years of service
- Financial Adoption Assistance and Medical Travel Reimbursement Programs
- Annual reimbursement up to $600 for health club membership or fees associated with any fitness program
- Company paid subscription to Headspace to support employees’ mental health and wellbeing
- 2024 Gold level recipient of Cigna’s Healthy Workforce Designation for having a best-in-class health and wellness program
- Dynamic, creative and values-driven culture
- Modern and open office spaces, complimentary drinks
- Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation
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