Claims Examiner - Liability BI/Auto exp required (REMOTE)

Lensa; Charlotte (NC); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading company is seeking a Claims Examiner to analyze complex liability claims in a remote setting. The role involves negotiating settlements, managing litigation, and ensuring compliance with industry standards. Candidates should have significant experience in claims management and strong communication skills. Join a supportive team that values diversity and offers opportunities for professional growth.

Qualifications

• Five years of claims management experience or equivalent.
• Professional certification relevant to line of business is a plus.

Responsibilities

• Analyze and process complex general liability claims.
• Negotiate settlement of claims within designated authority.
• Manage litigation process and ensure timely resolution.

Skills

Communication

Negotiation

Analytical Skills

Organizational Skills

Interpersonal Skills

Education

Bachelor's degree

Tools

Microsoft Office

Job description

Claims Examiner - Liability BI/Auto exp required (REMOTE)

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Lensa is the leading career site for job seekers at every stage of their career. Our client, Sedgwick, is seeking professionals. Apply via Lensa today!

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 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

Primary Purpose

To analyze complex or technically difficult general liability claims to determine benefits due; work with high exposure claims involving litigation and rehabilitation; ensure ongoing adjudication of claims within service expectations, industry best practices, and specific client requirements; and identify subrogation of claims and negotiate settlements.

Essential Functions and Responsibilities

• Analyze and process complex or technically difficult general liability claims by investigating and gathering information to determine exposure; manage claims through action plans to resolution.
• Assess liability and resolve claims within evaluation.
• Negotiate settlement of claims within designated authority.
• Calculate and assign reserves to claims; manage reserve adequacy throughout the claim's life.
• Calculate and pay benefits; approve and make timely payments and adjustments; settle claims within authority.
• Prepare necessary state filings within statutory limits.
• Manage litigation process; ensure timely, cost-effective resolution.
• Coordinate vendor referrals for investigation and litigation management.
• Use cost containment techniques including vendor partnerships to reduce overall claims costs.
• Manage claim recoveries, including subrogation, excess recoveries, and offsets.
• Report claims to excess carriers; respond to requests professionally and promptly.
• Communicate claim activity with claimants and clients; maintain professional relationships.
• Ensure proper documentation and coding of claim files.
• Refer cases to supervisor/management as appropriate.

Additional Functions and Responsibilities

• Perform other duties as assigned.
• Support quality programs.
• Travel as required.

Qualifications

Education & Licensing

Bachelor's degree preferred; professional certification relevant to line of business is a plus.

Experience

Five (5) years of claims management experience or equivalent.

Skills & Knowledge

• Subject matter expertise in insurance principles, recoveries, claim and disability management, and applicable laws.
• Excellent communication, presentation, and negotiation skills.
• Proficient in Microsoft Office and analytical skills.
• Strong organizational and interpersonal skills.
• Ability to work in a team and meet service expectations.

Work Environment

Includes considerations for mental, physical, auditory, and visual requirements. Reasonable accommodations will be considered.

Note: Credit security clearance via background check is required.

Additional Information

Statements are general; duties may change at management's discretion. Sedgwick is an Equal Opportunity Employer and Drug-Free Workplace.

If your experience doesn't match all qualifications, consider applying anyway. Sedgwick values diversity and unique skills.

Sedgwick is a global leader in risk and claims solutions, leveraging advanced AI technology, with over 33,000 colleagues and 10,000 clients worldwide.