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Sedgwick

Sedgwick, headquartered in Memphis, Tennessee, provides a global clientele with technology-enabled risk and benefits solutions. Distinguished as an Employer of

Claims Examiner – General Liability

Claims SpecialistClaims SpecialistFull TimeRemoteSeniorTeam 10,001Company Site

Location

Florida + 3 moreAll locations: Florida, North Carolina, Virginia, Wisconsin

Posted

13 days ago

Salary

$75K - $80K / year

Seniority

Senior

Bachelor Degree4 yrs expEnglish

Job Description

• Analyze mid- and higher-level general liability claims to determine benefits due • Ensure ongoing adjudication of claims within company standards and industry best practices • Identify subrogation of claims and negotiate settlements • Manage mid-level general liability claims by gathering information to determine liability exposure • Assign reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level • Assess liability and resolve claims within evaluation • Approve and process assigned claims, determine benefits due, and manage action plan pursuant to the claim or client contract • Manage subrogation of claims and negotiate settlements • Communicate claim action with claimant and client • Ensure claim files are properly documented and claims coding is correct • May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review

Job Requirements

  • Bachelor's degree from an accredited college or university preferred
  • Four (4) years of claims management experience or equivalent combination of education and experience required
  • Subject matter expert of appropriate insurance principles and laws for line-of-business handled
  • 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 Expectations

Benefits

  • medical
  • dental
  • vision
  • 401k and matching
  • PTO
  • disability and life insurance
  • employee assistance
  • flexible spending or health savings account
  • other additional voluntary benefits

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