Claims Examiner, Auto | Bodily Injury

Sedgwick; San Antonio (TX); Remote; USD 60,000 - 90,000; Full time

Job summary

Sedgwick is seeking a Claims Examiner, Auto | Bodily Injury, to analyze and process complex bodily injury auto and commercial transportation claims. The role involves reviewing coverage, investigating liability, and evaluating damages to ensure timely resolution in line with client expectations.

Ideal candidates will have five years of claims management experience, strong communication skills, and the ability to work in a team.

Qualifications

• Five years of claims management experience or equivalent combination.
• In-depth knowledge of personal and commercial auto policies, coverage, principles, and laws.
• Bachelor's degree preferred.
• Professional certification relevant to line of business preferred.
• Strong oral and written communication; PC literate; team oriented.

Responsibilities

• Analyze and process complex auto bodily injury and commercial transportation claims.
• Review coverage, determine liability, and evaluate damages.
• Coordinate with vendors and independent adjusters for investigations.
• Report large claims to excess carriers.
• Develop action plans to meet state contact deadlines and move files toward resolution.
• Identify subrogation and risk-transfer opportunities; dispose of salvage.
• Communicate claim actions with insured, client, and broker as appropriate.
• Travel as required and support quality programs.

Skills

Oral communication

Written communication

Presentation skills

MS Office

Team collaboration

Education

Bachelor's degree preferred

Job description

Telecommuter TX

Telecommuter FL

Telecommuter OK

Telecommuter AZ

Telecommuter TN

R73832

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.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Claims Examiner, Auto | Bodily Injury

PRIMARY PURPOSE OF THE ROLE:

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

ARE YOU AN IDEAL CANDIDATE?

To analyze complex auto bodily injury claims on behalf of our valued clients by evaluating coverage, investigating liability, and managing damages, while ensuring timely resolution within service expectations, industry best practices, and specific client requirements.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

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

QUALIFICATIONS

Education & Licensing: 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.

• Bachelor's degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• Skills: strong oral and written communication, including presentation skills, PC literate including Microsoft Office products, and ability to work in a team environment.
• Secure and maintain the State adjusting licenses as required for the position.

Work environment requirements include –

Physical: Computer keyboarding

Auditory/visual: Hearing, vision and talking

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

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.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

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