Claims Examiner - Auto

Sedgwick; Canada; Remote; CAD 65,000 - 90,000; Full time

Job summary

Sedgwick in Canada is seeking a Claims Examiner - Auto for a telecommuter, full-time role. You will analyze and process auto and commercial transportation claims, review coverage, conduct investigations, determine liability, and assess damages.

You will work with insureds, clients, and brokers; manage litigation for litigated claims; coordinate with independent adjusters; and pursue subrogation opportunities while ensuring deadlines and quality standards.

Qualifications

• Bachelor's degree preferred; professional certification as applicable to line of business preferred.
• Five (5) years of claims management experience with auto lines preferred; knowledge of personal and commercial auto policies.

Responsibilities

• Processes auto and commercial line claims, including bodily injury, and ensures files are documented and coded correctly.
• Responsible for litigation on litigated claims.
• Coordinates vendor management and independent adjusters for investigations.
• Reports large claims to excess carriers.
• Maintains action plans to meet deadlines and resolve files.
• Identifies subrogation and risk transfer opportunities; handles salvage.

Skills

Auto policy knowledge

Commercial auto knowledge

Medical terminology

Liability assessment

Communication skills

MS Office

Organization

Interpersonal skills

Negotiation

Teamwork

Service mindset

Education

Bachelor's degree

Tools

MS Office

Job description

Canada Telecommuter

Full time

R79919

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.

Claims Examiner - Auto

PRIMARY PURPOSE : To analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Processes complex auto commercial and personal line 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

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 the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see sedgwick.com