Sedgwick is looking for a Claims Examiner specializing in Liability to join our team. In this remote role, you will analyze mid- and higher-level general liability claims to determine benefits due, ensure adjudication aligns with company standards and industry best practices, and identify subrogation opportunities while negotiating settlements.
What You'll Do
- Manage mid-level general liability claims by gathering information to determine liability exposure.
- Assign reserve values to claims, make claims payments as necessary, and settle claims up to designated authority level.
- Assess liability and resolve claims within evaluation.
- Approve and process assigned claims, determine benefits due, and manage the action plan per the claim or client contract.
- Manage subrogation of claims and negotiate settlements.
- Communicate claim action with claimants and clients.
- Ensure claim files are properly documented and claims coding is correct.
- May process complex lifetime medical and/or defined period medical claims, including state and physician filings and decisions on treatments.
- Maintain professional client relationships.
- Support the organization's quality program(s).
- Travel as required.
What We're Looking For
- Four (4) years of claims management experience or equivalent combination of education and experience required.
Nice to Have
- Bachelor's degree from an accredited college or university preferred.
Benefits & Compensation
- Flexible work schedule.
- Referral incentive program.
- Career development and promotional growth opportunities.
- A diverse and comprehensive benefits offering including medical, dental, vision, and 401K on day one.
Work Mode
This position is eligible for a fully remote work arrangement.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
