Claims Analyst: Complex & High-Value Settlements

Sedgwick; Seven Hills (OH); On-site; USD 45,000 - 65,000; Full time

Job summary

Sedgwick in the United States is seeking a Claims Representative - Consumer to analyze reports, determine benefits, and make timely payments and adjustments for a range of consumer claims. You will coordinate investigations, review contested claims, and negotiate settlements within your authority.

The role emphasizes delivering superior customer service, handling high volumes, and collaborating with underwriters and clients while maintaining accurate documentation and adherence to deadlines.

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• Three years of claims management experience or equivalent combination required.
• Strong knowledge of first party property and casualty claim adjudication.

Responsibilities

• Manages first party property, casualty and/or medical reimbursement claims based on client-specific program.
• Makes coverage determinations based on investigation/evaluation and communicates claim actions with claimant and client.
• Adjudicates proper settlement up to designated authority level.
• Works directly with underwriter/client on high value and complex cases.
• Handles high volume of claims, phone calls and correspondence ensuring claim files are properly documented; meets quality and production goals; and meets customer guidelines and deadlines.

Skills

Claim adjudication

Communication

PC literacy

Analytical skills

Organization

Interpersonal skills

Teamwork

Performance competencies

Education

Bachelor's degree

Tools

Microsoft Office

Job description

Sedgwick in the United States is seeking a Claims Representative - Consumer to analyze reports, determine benefits, and make timely payments and adjustments for a range of consumer claims. You will coordinate investigations, review contested claims, and negotiate settlements within your authority.

The role emphasizes delivering superior customer service, handling high volumes, and collaborating with underwriters and clients while maintaining accurate documentation and adherence to deadlines.