Claims Examiner - Liability | GL Litigation | REMOTE

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands? 

• Apply your General Liability and litigated claims knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. 
• Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations. 
• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. 
• Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights. 
• Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. 
• Enjoy flexibility and autonomy in your daily work, your location, and your career path. 
• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. 

PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

ARE YOU AN IDEAL CANDIDATE? To analyze claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim. 
• Negotiating settlement of claims within designated authority. 
• Communicating claim activity and processing with the claimant and the client. 
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
• 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.
• Ability to review, understand and interpret contracts.

QUALIFICATIONS

Education & Licensing: 4+ years of claims management experience or equivalent combination of education and experience required.

• High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred. 
• Professional certification as applicable to line of business preferred.

Licensing / Jurisdiction Knowledge:

Home State License and ability to obtain New York licensing is a requirement for this role

TAKING CARE OF YOU

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. 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 jurisdiction noted in this job posting only, the range of starting pay for this role is $63,000 to $88,765.  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.

• Flexible work schedule. 
• Referral incentive program. 
• Opportunity to work in an agile environment. [IF APPLICABLE] 
• Career development and promotional growth opportunities. 
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

Work environment requirements for entry-level opportunities include –

Physical: Computer keyboarding

Auditory/visual: Hearing, vision and talking

Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.