See all roles

Claims Examiner, Bodily Injury | Remote | Litigation

Work from home Full-time role Hiring

This a Full Remote job, the offer is available from: United States, Arkansas (USA), Texas (USA), Wisconsin (USA) By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Examiner, Bodily Injury | Remote | Litigation PRIMARY PURPOSE: To analyze and process complex auto bodily injury transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages. ESSENTIAL FUNCTIONS and RESPONSIBILITIES

  • Processes complex auto claims, including bodily injury and ensures claim files are properly documented and coded correctly.
  • Responsible for litigation process on litigated claims.
  • Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims.
  • Reports large claims to excess carrier(s).
  • Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.
  • Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage.
  • Communicates claim action/processing with insured, client, and agent or broker when appropriate.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

  • Performs other duties as assigned.
  • Supports the organization's quality program(s).
  • Travels as required.

QUALIFICATIONS Education & Licensing Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Secure and maintain the State adjusting licenses as required for the position. Experience Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage’s, principles, and laws. Skills & Knowledge

  • In-depth knowledge of personal and commercial line auto policies, coverage’s, principles, and laws
  • Knowledge of medical terminology for claim evaluation and Medicare compliance
  • Knowledge of appropriate application for deductibles, sub-limits, SIR’s, carrier and large deductible programs.
  • Strong oral and written communication, including presentation skills
  • PC literate, including Microsoft Office products
  • Strong organizational skills
  • Strong interpersonal skills
  • Good negotiation skills
  • Ability to work in a team environment
  • Ability to meet or exceed Service Expectations

WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Computer keyboarding, travel as required Auditory/Visual: Hearing, vision and talking The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles. This offer from "Sedgwick" has been enriched by Jobgether.com and got a 75% flex score. Apply tot his job Apply To this Job

You might like

Clinical Review QC Auditor, TX

Work from home Full-time role

Healthcare Administration - Compliance Manager

Work from home Full-time role

Research Scientist- Immunoassay Development

Work from home Full-time role

Adjunct Faculty – Biochemistry & Biophysics for Discovery

Work from home Full-time role

26 AY Teaching Associate (TA) – Chemistry & Biochemistry

Work from home Full-time role

Cleveland Clinic Professional Fee Coder III – Anesthesia (Fully Remote) in Cleveland, Ohio

Work from home Full-time role

Program Coordinator /Patient Scheduler- Urology Clinic

Work from home Full-time role

Experienced Weekend Customer Service Representative – Full Remote Opportunity in the US, Utilizing Excellent Communication Skills to Deliver Top-Notch Service

Work from home Full-time role

Bilingual (English/Spanish) Customer Service Representative

Work from home Full-time role

Clinical Auditing Nurse- Remote /CA license/

Work from home Full-time role

Experienced Remote Data Entry Clerk Opportunity – Flexible Work Setup for Self-Motivated Individuals

Work from home Full-time role

Care Manager (Certified Medical Assistant-TeleHealth) - English, Urdu, & Japanese language preferred

Work from home Full-time role

Provider Support Specialist

Work from home Full-time role

Walmart Remote Online Jobs

Work from home Full-time role

SAP COORDINATOR COL ABAP

Work from home Full-time role

Wayfair Remote Part-Time ? WFH

Work from home Full-time role

Experienced Customer Service Coordinator – Business and Government Customer Organization (BGCO) at arenaflex

Work from home Full-time role

Proposals & Adoptions Writer

Work from home Full-time role

Claims Manager (m/f/d)

Work from home Full-time role

Implementation Project Coordinator

Work from home Full-time role