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.
SE
Hybrid Claims Adjuster – Bodily Injury, Jurisdiction: All States, Licensing: FL, TX, GA preferred
Posted last month
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 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.