Claims Associate responsible for managing workers compensation claims within company standards. Providing client support and documenting claims accurately while ensuring efficient processing in the Plano office.
SE
Hybrid Claims Adjuster – Bodily Injury, Jurisdiction: All States, Licensing: FL, TX, GA preferred
Posted 4 hours ago
About the role
- Claims Adjuster managing general liability and bodily injury claims at Sedgwick. Utilizing expertise to adjudicate claims and maintain professional client relationships while ensuring compliance.
Responsibilities
- Manage mid-level general liability claims by gathering information to determine liability exposure;
- Assign reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.
- Assess liability and resolve claims within evaluation.
- Approve and process assigned claims, determine benefits due, and manage action plan pursuant to the claim or client contract.
- Manage subrogation of claims and negotiate settlements.
- Communicate claim action with claimant and client.
- Ensure claim files are properly documented and claims coding is correct.
- Process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
- Maintain professional client relationships.
Requirements
- Bachelor's degree from an accredited college or university preferred.
- Licenses as required.
- Professional certifications as applicable to line of business preferred.
- Four (4) years of claims management experience or equivalent combination of education and experience required.
Benefits
- Flexible work schedule.
- Referral incentive program.
- Career development and promotional growth opportunities.
- A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
Claims Examiner analyzing workers' compensation claims for clients, ensuring benefits are adjudicated within service expectations and industry best practices. Requires significant claims management experience and knowledge of California regulations.
Claims Examiner handling customer benefit payments and ensuring compliance at Securian Financial. Processing claims efficiently while maintaining high standards of customer service and communication.
Fraud Triage Specialist responsible for identifying fraud indicators in insurance claims. Analyzing information and collaborating with investigative teams within the Claims department.
Complex Claims Specialist handling Miscellaneous Professional Liability claims from inception to resolution at Hiscox. Involves negotiation, settlement, and litigation support with a focus on positive outcomes.
Field Claims Adjuster managing claims while ensuring business development in the Victoria area. Provide high - level customer service and adjust claims effectively within a hybrid environment.
Claims Specialist handling commercial property claims with a focus on subscription policies at Swiss Re. Collaborating with stakeholders to ensure accurate and fair claims resolution.
Workers Compensation Claims Examiner adjudicating complex customer claims at Sedgwick. Delivering solutions in a hybrid work environment to meet client expectations.
Claims Associate analyzing claims for a global industry leader. Delivering customer - facing solutions with innovative problem - solving in the context of an energetic culture.
Senior Claims Specialist managing General Liability claims within a team at Zurich. Collaborating with internal/external partners and delivering customer - centric claims service.