Liability Claims Examiner — Hybrid/Remote Role

Sedgwick; Erie (Erie County); Hybrid; USD 85,000 - 90,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

Comprehensive benefits package

Job summary

Sedgwick in Marlton, NJ is seeking a Liability Claims Examiner to analyze complex general liability, premise liability and litigated claims on the East Coast. The role focuses on determining benefits due, managing disputes, and delivering client-focused solutions within a collaborative, caring culture.

You will adjudicate claims, negotiate settlements, reserve appropriately, and coordinate with vendors and clients.

Qualifications

• Five (5) years of claims management experience or equivalent combination of education and experience required.
• Bachelor's degree preferred; professional certification as applicable to line of business preferred.
• Licensing: Home State preferred.

Responsibilities

• Analyzes and processes complex or technically difficult general liability claims by investigating and gathering information to determine exposure on the claim; manages claims through well-developed action plans to a 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; settles claims within designated authority level.
• Prepares necessary state filings within statutory limits.
• Manages the litigation process; ensures timely and cost effective claims resolution.
• Coordinates vendor referrals for additional investigation and/or litigation management.
• Uses cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for clients.
• Manages claim recoveries (subrogation, Second Injury Fund excess recoveries, Social Security and Medicare offsets).
• Reports claims to the excess carrier; responds to directions in a timely manner.
• Communicates claim activity with the claimant and client; maintains professional client relationships.
• Ensures claim files are properly documented and claims coding is correct.
• Refers cases to supervisor/management.
• Performs other duties as assigned.
• Supports the organization's quality program(s).
• Travels as required.

Education

Bachelor's degree

Professional certification (as applicable)

Job description

Sedgwick in Marlton, NJ is seeking a Liability Claims Examiner to analyze complex general liability, premise liability and litigated claims on the East Coast. The role focuses on determining benefits due, managing disputes, and delivering client-focused solutions within a collaborative, caring culture.

You will adjudicate claims, negotiate settlements, reserve appropriately, and coordinate with vendors and clients.