Liability Adjuster

PVH (Tommy Hilfiger/Calvin Klein); Deutschland; Vor Ort; EUR 35.211 - 56.337; Vollzeit

Zusammenfassung

Sedgwick seeks a Liability Adjuster to analyze mid- and higher-level general liability claims, determine benefits due, and adjudicate within company standards. The role involves negotiating settlements and managing subrogation while maintaining strong client relationships.

Responsibilities include gathering information, assigning reserves, processing payments, and ensuring claim files are accurately documented.

Qualifikationen

• Bachelor's degree or college diploma preferred.

Aufgaben

• Analyze mid- and higher-level general liability claims to determine benefits due.
• Assess liability and resolve claims within evaluation.
• Approve and process assigned claims, determine benefits due, and manage action plans.
• Manage subrogation of claims and negotiate settlements.
• Communicate claim actions with claimants and clients.
• Ensure claim files are properly documented and coded.

Kenntnisse

Claims management

Negotiation

Communication

Analytical skills

Organization

Teamwork

Problem solving

Ausbildung

Bachelor's degree or college diploma

Tools

Microsoft Office

Jobbeschreibung

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.

Liability Adjuster

PRIMARY PURPOSE

To analyze mid- and higher-level general liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Manages mid-level general liability claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.
• Assesses liability and resolves claims within evaluation.
• Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
• Manages subrogation of claims and negotiates settlements.
• Communicates claim action with claimant and client.
• Ensures 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.
• Maintains professional client relationships.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

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

QUALIFICATION

Education & Licensing

Bachelor's degree or college diploma preferred.

Experience

Four (4) 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
• Excellent oral and written communication
• 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

Job type: We are currently hiring for this position

Compensation Information

Salary Range: $56,539.00 - 73,501.00 - 90,462.00 CAD Annual

This position is full-timefull-time, andand compensation is salaried.

Compensation is determined based on experience, qualifications, and internal equity. Sedgwick is committed to transparent and equitable pay practices.

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.

Where applicable, Sedgwick uses artificial intelligence tools to assist in the screening, assessment, or selection of candidates. These tools are subject to periodic review.

We are committed to inclusive, barrier-free recruitment and selection processes. If contacted for an employment opportunity, please advise Colleague Resources if you require accommodation.

Sedgwick is an Equal Opportunity Employer