Remote Claims Examiner - PIP/Med Pay Specialist

Sedgwick; Columbia (SC); Remote; USD 75,000 - 85,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401K on day one

Job summary

Sedgwick is seeking a Claims Examiner to investigate, negotiate, and resolve PIP/Med Pay claims across jurisdictions, with emphasis on New Jersey. You’ll guide insureds and claimants through the process, document reasoning, and manage claim progress.

The role requires 6+ years in related claims, 3+ years in PIP/Med Pay, and appropriate licenses. Work-life balance and strong benefits are highlighted, with a US telecommuter setup.

Qualifications

• Minimum six years of related experience, including three years in PIP/Med Pay adjusting.
• Bachelor's degree preferred.
• Licenses/certifications as required for the jurisdiction.

Responsibilities

• Investigates, negotiates, and resolves PIP/Med Pay claims per policy and jurisdiction.
• Documents analysis, evaluation, and settlement decisions clearly.
• Maintains reserves and issues payments with proper authorization.

Skills

PIP/Med Pay adjusting

Negotiation

Investigative skills

Education

Bachelor's degree

Professional certification (preferred)

Job description

Sedgwick is seeking a Claims Examiner to investigate, negotiate, and resolve PIP/Med Pay claims across jurisdictions, with emphasis on New Jersey. You’ll guide insureds and claimants through the process, document reasoning, and manage claim progress.

The role requires 6+ years in related claims, 3+ years in PIP/Med Pay, and appropriate licenses. Work-life balance and strong benefits are highlighted, with a US telecommuter setup.