Liability Claims Specialist – Resolve & Negotiate

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

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.