Claims Examiner - Bodily Injury

Sedgwick Claims Management Services Inc.; United States; Remote; USD 80,000 - 85,000; Full time

Benefits offered by this job

Flexible work schedule

Career development and growth

Medical, dental, vision, 401K on day 1

Referral incentive program

Job summary

Sedgwick is seeking a Claims Examiner - Bodily Injury to analyze and process complex auto and commercial transport bodily injury claims, reviewing coverage, investigating liability, and evaluating damages. You will ensure timely resolution, follow client requirements, and manage internal processes and external vendor coordination to deliver quality outcomes.

Ideal candidates have 5+ years of claims management, strong communication, and licenses; Bachelor's preferred; professional certification

Qualifications

• Five years of claims management experience with auto policies.
• Bachelor's degree preferred.
• Professional certification preferred.
• Strong oral and written communication; proficient in MS Office; team player.
• State adjusting licenses required/maintained.

Responsibilities

• Process complex auto bodily injury claims; document and code files.
• Coordinate litigation processes on litigated claims.
• Coordinate vendor management, including independent adjusters.
• Report large claims to excess carriers.
• Develop action plans to meet state deadlines and resolve files.
• Identify subrogation and risk transfer opportunities.
• Communicate claim actions with insured, clients, or agents.
• Perform other duties as assigned.
• Support the organization’s quality programs.

Skills

Communication skills

Presentation skills

Teamwork

MS Office

Education

Bachelor's degree

Professional certification

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 - 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).

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.

TAKING CARE OF YOU

• Flexible work schedule.

• Referral incentive program.

• Career development and promotional growth opportunities.

• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

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 $80,000 to $85,000. 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 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.

Sedgwickis 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.