Hybrid Claims Adjuster – Liability

at Sedgwick

• Job title: Claims Adjuster – Liability
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: Not specified
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Irving, United States

About the role

• Claims Adjuster managing mid- to higher-level general liability claims for Sedgwick. Analyzing claims, negotiating settlements, and maintaining client relationships.

Responsibilities

• To analyze mid- and higher-level general liability claims to determine benefits due;
• To ensure ongoing adjudication of claims within company standards and industry best practices;
• To identify subrogation of claims and negotiate settlements.
• Manages mid-level general liability claims by gathering information to determine liability exposure;
• Assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.
• Assesses liability and resolves claims within evaluation.
• Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
• Manages subrogation of claims and negotiates settlements.
• Communicates claim action with claimant and client.
• Ensures claim files are properly documented and claims coding is correct.
• May 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.
• Maintains professional client relationships.
• Performs other duties as assigned.
• Supports the organization's quality program(s).

Requirements

• Bachelor's degree from an accredited college or university preferred.
• Four (4) years of claims management experience or equivalent combination of education and experience required.

Benefits

• Flexible Work Schedule
• Referral Incentive Program
• Opportunity to work from home
• Career development and promotional growth opportunities
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day 1