Claims Examiner, Auto | General Liability | Bodily Injury | New Jersey ClaimsRequired

Sedgwick

Bristol (RI)

On-site

USD 70,000 - 80,000

Full time

8 days ago

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Benefits offered by this job

Medical benefits
Dental benefits
Vision benefits
401k with matching
PTO
Disability insurance
Life insurance
Employee assistance program
FSA/HSAs

Job summary

Sedgwick in the United States is seeking a Claims Examiner to investigate, evaluate, negotiate, and resolve complex auto, general liability, and bodily injury claims while delivering exceptional service to clients and claimants. This role focuses on high-exposure matters, timely resolution, and compliance with regulatory requirements.

Five years of claims handling experience is required, with a bachelor’s degree preferred and industry certifications beneficial.

Qualifications

  • Five years of claims handling experience or equivalent
  • Experience handling complex general liability claims preferred
  • Litigation management experience preferred
  • Bachelor's degree from accredited college preferred
  • Industry certifications preferred

Responsibilities

  • Investigate, evaluate, negotiate, and resolve complex general liability claims.
  • Manage high-exposure claims including litigated matters.
  • Develop strategic claim action plans to drive timely and cost-effective outcomes.
  • Assess liability and negotiate settlements within authority.
  • Maintain claim reserves and authorize payments within delegated authority.

Skills

General liability claims
Negotiation
Litigation management
Investigation

Education

Bachelor's degree preferred

Tools

Microsoft Office
Claims management systems

Job description

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 | General Liability | Bodily Injury | New Jersey Claims Required PRIMARY PURPOSE OF THE ROLE

To investigate, evaluate, negotiate, and resolve complex general liability claims while ensuring excellent service delivery to clients and claimants. This role manages high-exposure claims, including litigated matters, with a focus on timely resolution, cost containment, and compliance with client and regulatory requirements.

  • Analyze and manage complex or technically challenging general liability claims from inception through resolution.
  • Conduct thorough investigations to determine liability, damages, and claim exposure.
  • Develop and execute strategic claim action plans to drive timely and appropriate claim outcomes.
  • Assess liability and negotiate settlements within assigned authority limits.
  • Calculate, establish, and maintain appropriate claim reserves throughout the life of the claim.
  • Authorize and process claim payments and adjustments within delegated authority.
  • Ensure compliance with applicable laws, regulations, and client-specific requirements.
  • Prepare and submit required state filings within statutory deadlines.
  • Report claims to excess carriers and respond promptly to requests for information or direction.
  • Manage litigated claims through effective collaboration with defense counsel and external partners.
  • Coordinate vendor referrals for investigations, medical reviews, surveillance, and litigation management services.
  • Utilize cost-containment strategies and strategic vendor partnerships to help reduce overall claim costs.
  • Pursue and manage claim recoveries, including subrogation and applicable offsets.
  • Maintain proactive communication with claimants, clients, attorneys, and other stakeholders.
  • Build and maintain strong client relationships through professional and responsive service.
  • Ensure claim files are accurately documented and coded in accordance with company standards.
  • Escalate complex issues and high-exposure matters to leadership as appropriate.
  • Perform other duties as assigned.

Education & Experience: Five (5) years of claims handling experience, or an equivalent combination of education and relevant experience.

  • Experience handling complex general liability claims preferred.
  • Litigation management experience strongly preferred.
  • Bachelor's degree from an accredited college or university preferred.
  • Industry certifications relevant to the line of business are preferred.
SKILLS & KNOWLEDGE
  • Strong knowledge of general liability claims practices, insurance principles, and applicable regulations.
  • Understanding of recovery opportunities, subrogation, offsets, and cost containment strategies.
  • Excellent verbal, written, and presentation communication skills.
  • Strong analytical, investigative, and problem-solving abilities.
  • Effective negotiation and settlement management skills.
  • Ability to prioritize workload and manage multiple competing priorities.
  • Demonstrated ability to work independently and collaboratively within a team environment.
  • Proficiency with Microsoft Office applications and claims management systems.
  • Commitment to delivering exceptional customer and client service.

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.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $70,000 to $80,000. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

The statements contained in this description are intended to describe the general nature and level of work being performed. They are not intended to be an exhaustive list of all responsibilities, duties, or requirements. Management reserves the right to modify, add, or remove duties as business needs require.

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

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.

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