Sedgwick is looking for a Claims Examiner to analyze complex and technically difficult auto, general liability, and bodily injury claims. In this remote role, you will manage high-exposure claims involving litigation and rehabilitation, ensuring adjudication aligns with service expectations and industry best practices.
What You'll Do
- Analyze and process complex general and auto liability claims to determine exposure.
- Manage claims through developed action plans to achieve timely resolution.
- Assess liability and negotiate settlements within designated authority.
- Calculate and assign timely, appropriate claim reserves and manage reserve adequacy.
- Approve and make timely claim payments, adjustments, and settlements.
- Prepare necessary state filings within statutory limits.
- Manage the litigation process to ensure cost-effective claims resolution.
- Coordinate vendor referrals for investigation and litigation management.
- Use cost containment techniques and strategic vendor partnerships.
- Manage claim recoveries, including subrogation and offsets.
- Report claims to excess carriers and respond to direction requests professionally.
- Communicate claim activity clearly with claimants and clients.
- Ensure claim files are properly documented and coded correctly.
- Refer cases as appropriate to supervisor and management.
- Support the organization's quality programs.
- Travel as required.
What We're Looking For
- Five (5) years of claims management experience or an equivalent combination of education and experience.
- An active NY, FL, and/or TX adjuster license is required.
Nice to Have
- Bachelor's degree from an accredited college or university.
- Professional certification relevant to the line of business.
Benefits & Compensation
- Flexible work schedule.
- Referral incentive program.
- Opportunity to work in an agile environment.
- Career development and promotional growth opportunities.
- A diverse and comprehensive benefits offering including medical, dental, vision, and 401K on day one.
Work Mode
This is a fully remote position.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
