Claims Representative - Liability

Sentry Insurance; Madison (WI); Hybrid; USD 50,000 - 75,000; Full time

Benefits offered by this job

Hybrid work flexibility

Tuition reimbursement

Comprehensive benefits package

401(k) match

Job summary

Sentry Insurance is seeking a Claims Representative-Liability to investigate and resolve complex claims with accuracy and fairness. The role requires managing caseloads, negotiating settlements, and maintaining compliance with regulations and internal policies.

You will review policy terms, gather evidence, take statements, and collaborate with medical providers and other stakeholders to support timely, fair resolutions. Licensing and strong communication are essential to success.

Qualifications

• Bachelor's degree or equivalent work experience.
• Minimum 1 year of related work experience.
• Prior attorney rep experience highly preferred
• Ability to review and analyze detailed documents, insurance policies, coverages, medical bills and records
• Ability to make appropriate claim decisions, prioritize, and manage workload; time limit demands
• Effective verbal and written communication skills
• Demonstrated fundamental negotiation skills

Responsibilities

• Verify coverage by thoroughly reviewing the policies and interpreting policy terms, conditions and language.
• Evaluate liability by taking recorded statements, reviewing police reports, and compiling other pertinent evidence. Negotiate or deny liability based on the investigation outcome.
• Evaluate physical damage and bodily injury claims based on estimates, photos, appraisals, medical reports, medical bills, and other evidence.
• Set appropriate claim reserves in a timely manner based on ongoing evaluations of liability. Negotiate bodily injury settlements with policyholders, claimants, attorneys, and other insurance carriers to reach fair resolutions within established guidelines.
• Ensure compliance with industry regulations, legal requirements, and internal policies by thoroughly documenting all decisions, communications, and activities throughout the entire claims process.
• Provide empathetic and supportive service to customers as they navigate challenging situations, clearly explaining the claims process, keeping them informed of their claim process, and communicating decisions along with the reasoning behind them.
• Ability to obtain and maintain state licensing requirements

Skills

Policy review

Negotiation skills

Communication

Decision making

Education

Bachelor's degree or equivalent

Job description

You will investigate and resolve insurance claims with a focus on accuracy, efficiency, and fair resolution and independently manage caseloads and negotiate settlements.

What You'll Do

As a Claims Representative-Liability, you will:

• Verify coverage by thoroughly reviewing the policies and interpreting policy terms, conditions and language.
• Evaluate liability by taking recorded statements, reviewing police reports, and compiling other pertinent evidence. Negotiate or deny liability based on the investigation outcome.
• Evaluate physical damage and bodily injury claims based on estimates, photos, appraisals, medical reports, medical bills, and other evidence. Working closely with medical providers, repair shops and/or contractors to facilitate necessary and related services.
• Set appropriate claim reserves in a timely manner based on ongoing evaluations of liability. Negotiate bodily injury settlements with policyholders, claimants, attorneys, and other insurance carriers to reach fair resolutions within established guidelines. Ensure claims are paid promptly and within authorized limits.
• Ensure compliance with industry regulations, legal requirements, and internal policies by thoroughly documenting all decisions, communications, and activities throughout the entire claims process.
• Provide empathetic and supportive service to customers as they navigate challenging situations, clearly explaining the claims process, keeping them informed of their claim process, and communicating decisions along with the reasoning behind them.
• Ability to obtain and maintain state licensing requirements

What it Takes

• Bachelor's degree or equivalent work experience
• Minimum 1 year of related work experience
• Prior attorney rep experience highly preferred
• Ability to review and analyze detailed documents, insurance policies, coverages, medical bills and records
• Ability to make appropriate claim decisions, prioritize, and manage workload; time limit demands
• Effective verbal and written communication skills
• Demonstrated fundamental negotiation skills

Here is what you can look forward to as part of our team:

At Sentry, your total rewards go beyond competitive compensation. We're committed to supporting the whole you, which is why we offer a comprehensive package designed to help you thrive both professionally and personally.

• Hybrid Flexibility:Enjoy the best of both worlds. With optional work from home on Mondays and Fridays and join your team in the office Tuesday through Thursday to collaborate and learn. We provide the technology and tools you need for both your office and home workspace from day one.
• Dining on Us:Depending on your location, we may provide a stipend that can be used at our on-site cafeteria or a meal allowance to keep you fueled.
• Continuous Learning:Unlock your potential through Sentry University and take advantage of our tuition reimbursement program.
• Comprehensive Benefits:We support your whole self with group medical, dental, and vision insurance along with parental leave, pet insurance, caregiver leave, and wellness resources. Options for HSA, FSA, and Dependent Care FSA are available.
• Work-Life Balance:Enjoy your generous Paid Time Off allowance to rest and take advantage of paid Volunteer Time Off to support your community.
• Investing in Your Future:We're committed to your long-term financial well-being. We offer a 100% company match on the first 8% you contribute to your 401(k) each pay period, and those funds vest immediately.
• Giving Back:Through the Sentry Foundation, we're proud to support the United Way and make a difference in our communities.

Why Join Sentry?

At Sentry, we believe our people are the heart of our success. We're proud to be recognized for the culture we've built, earning spots on Forbes' lists for America's Best Midsize Employers and Best Employers for New Grads, as well as Newsweek's America's Greatest Workplaces for Women and Diversity. These honors reflect our commitment to your professional satisfaction and growth.

Building on a Legacy

Our future is bright, but it's anchored in a long history of stability. Since our founding in 1904, we've dedicated ourselves to helping businesses protect their futures. That trust has made us one of the largest and most financially stable mutual insurance companies in the U.S. We're proud to have maintained an A+ rating from A.M. Best, the industry's leading authority, for over 30 years.

Your Career, Our Community

Whether you're working at our headquarters in Stevens Point, Wisconsin, or one of our many offices across the country, you'll find a challenging and rewarding environment. Explore theOur Teamstab on our Career Page to see the diverse career paths we offer, with a focus on ongoing development and professional growth.

Equal Employment Opportunity

Sentry is an Equal Opportunity Employer. It is our policy that there be no discrimination in employment based on race, color, national origin, religion, sex, disability, age, marital status, or sexual orientation.