Claims Examiner - Liability (REMOTE- NY Adjuster Lic Required)

Sedgwick; Town of Florida (NY); Remote; USD 60,000 - 90,000; Full time

Job summary

A global claims management leader is seeking a remote Claims Examiner to analyze and negotiate complex general liability claims. The ideal candidate will have a Bachelor's degree and a NY Adjuster License, along with five years of experience in Workers Compensation claims. A flexible work schedule and comprehensive benefits are offered in this role.

Benefits

Flexible work schedule

Referral incentive program

Comprehensive benefits package

Qualifications

• Five years of experience in Workers Compensation claims management or equivalent required.
• Ability to analyze complex liability claims and negotiate settlements is essential.

Responsibilities

• Analyze and process complex general liability claims.
• Negotiate settlement of claims within designated authority.
• Manage litigation process for timely claims resolution.
• Ensure compliance with statutory limits.

Skills

Claims adjudication

Negotiation

Investigation

Analytical skills

Education

Bachelor's degree preferred

NY Adjuster License

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.

Sedgwick has been recognized as one of America’s Greatest Workplaces, a Great Place to Work, and one of the Fortune Best Workplaces in Financial Services & Insurance.

Job Title: Claims Examiner - Liability (REMOTE- NY Adjuster Lic Required)

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?

• Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
• Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.
• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
• Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.
• Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
• Enjoy flexibility and autonomy in your daily work, your location, and your career path.
• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

PRIMARY PURPOSE

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

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Analyzes and processes complex or technically difficult general liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
• Assesses liability and resolves claims within evaluation.
• Negotiates settlement of claims within designated authority.
• Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
• Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles claims within designated authority level.
• Prepares necessary state fillings within statutory limits.
• Manages the litigation process; ensures timely and cost effective claims resolution.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

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

QUALIFICATIONS

Education & Licensing: Bachelor's degree from an accredited college or university preferred. NY Adjuster License required.

Experience: Five (5) years of Workers Compensation claims management experience or equivalent combination of education and experience required.

BENEFITS

• 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.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. We recognize that each person possesses a unique combination of skills, knowledge, and experience, and we encourage you to apply even if your experience doesn't align perfectly with every qualification in the job description.