REMOTE Claims Examiner - Liability
Company: Sedgwick
Location: Jefferson City
Posted on: January 24, 2023
Job Description:
The 'Apply with SEEK' option will be utilized for International
applicants, mainly Australia. If this does not apply to you please
use the 'Apply' option.REMOTE Claims Examiner - LiabilityIF YOU
CARE, THERES A PLACE FOR YOU HEREFor a career path that is both
challenging and rewarding, join Sedgwicks talented team of 27,000
colleagues around the globe. Sedgwick is a leading provider of
technology-enabled risk, benefits and integrated business
solutions. Taking care of people is at the heart of everything we
do. Millions of people and organizations count on Sedgwick each
year to take care of their needs when they face a major life event
or something unexpected happens. Whether they have a workplace
injury, suffer property or financial loss or damage from a natural
or manmade disaster, are involved in an auto or other type of
accident, or need time away from work for the birth of a child or
another medical situation, we are here to provide compassionate
care and expert guidance. Our clients depend on our talented
colleagues to take care of their most valuable assetstheir
employees, their customers and their property. At Sedgwick, caring
counts. Join our team of creative and caring people of all
backgrounds, and help us make a difference in the lives of
others.With one of the largest teams of liability experts in the
world, Sedgwick supports and resolves property, general, auto,
product and professional liability claims. We help our clients
maintain brand protection in times of crisis.PRIMARY PURPOSE : To
analyze complex or technically difficult general liability claims
to determine benefits due; to work with high exposure claims
involving litigation and rehabilitation; to ensure ongoing
adjudication of claims within service expectations, industry best
practices and specific client service requirements; and to identify
subrogation of claims and negotiate settlements.ESSENTIAL FUNCTIONS
and RESPONSIBILITIES
- Analyzes and processes complex or technically difficult general
liability claims by investigating and gathering information to
determine the exposure on the claim; manages claims through
well-developed action plans to an appropriate and timely
resolution.
- Assesses liability and resolves claims within evaluation.
- Negotiates settlement of claims within designated
authority.
- Calculates and assigns timely and appropriate reserves to
claims; manages reserve adequacy throughout the life of the
claim.
- Calculates and pays benefits due; approves and makes timely
claim payments and adjustments; and settles clams within designated
authority level.
- Prepares necessary state fillings within statutory limits.
- Manages the litigation process; ensures timely and cost
effective claims resolution.
- Coordinates vendor referrals for additional investigation
and/or litigation management.
- Uses appropriate cost containment techniques including
strategic vendor partnerships to reduce overall cost of claims for
our clients.
- Manages claim recoveries, including but not limited to:
subrogation, Second Injury Fund excess recoveries and Social
Security and Medicare offsets.
- Reports claims to the excess carrier; responds to requests of
directions in a professional and timely manner.
- Communicates claim activity and processing with the claimant
and the client; maintains professional client relationships.
- Ensures claim files are properly documented and claims coding
is correct.
- Refers cases as appropriate to supervisor and
management.ADDITIONAL FUNCTIONS and RESPONSIBILITIES
- Performs other duties as assigned.
- Supports the organization's quality program(s).
- Travels as required.QUALIFICATIONEducation &
LicensingBachelor's degree from an accredited college or university
preferred. Professional certification as applicable to line of
business preferred.ExperienceFive (5) years of claims management
experience or equivalent combination of education and experience
required.Skills & Knowledge
- Subject matter expert of appropriate insurance principles and
laws for line-of-business handled, recoveries offsets and
deductions, claim and disability duration, cost containment
principles including medical management practices and Social
Security and Medicare application procedures as applicable to
line-of-business.
- Excellent oral and written communication, including
presentation skills
- PC literate, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skills
- Good interpersonal skills
- Excellent negotiation skills
- Ability to work in a team environment
- Ability to meet or exceed Service ExpectationsWORK
ENVIRONMENTWhen 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 deadlinesPhysical: Computer keyboarding, travel as
requiredAuditory/Visual: Hearing, vision and talkingNOTE : Credit
security clearance, confirmed via a background credit check, is
required for this position.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.#LI-TS1 #LI-CR1#REMOTEAs required by law, Sedgwick provides a
reasonable range of compensation for roles that may be hired in
(Colorado or New York City). Actual compensation is influenced by a
wide range of factors including but not limited to skill set, level
of experience, and cost of specific location. For the state noted
in this job posting only, the range of starting pay for this role
is 55K-77K. A comprehensive benefits package is offered including
but not limited to, medical, dental, vision, 401k and matching,
PTO, disability and life insurance, employee assistance, flexible
spending or health savings account, and other additional voluntary
benefits.Sedgwick is an Equal Opportunity Employer and a Drug-Free
Workplace.Taking care of people is at the heart of everything we
do. Caring countsSedgwick is a leading global provider of
technology-enabled risk, benefits and integrated business
solutions. Every day, in every time zone, the most well-known and
respected organizations place their trust in us to help their
employees regain health and productivity, guide their consumers
through the claims process, protect their brand and minimize
business interruptions. Our more than 30,000 colleagues across 80
countries embrace our shared purpose and values as they demonstrate
what it means to work for an organization committed to doing the
right thing one where caring counts. Watch this video to learn more
about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)
Keywords: Sedgwick, Jefferson City , REMOTE Claims Examiner - Liability, Other , Jefferson City, Missouri
Didn't find what you're looking for? Search again!
Loading more jobs...