Remote Liability Claims Examiner - Complex GL & Premises

Sedgwick; Norfolk (VA); Hybrid; USD 85,000 - 90,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development and promotional成长

Job summary

Sedgwick in Marlton, NJ is seeking a Liability Claims Examiner to adjudicate complex general liability, premise liability and litigated claims. The role involves investigating exposure, negotiating settlements, and managing reserves, with a hybrid schedule (2 days in-office) within commutable distance.

Ideal candidates have a Bachelor’s degree, 5 years of claims management experience, and relevant licensing. Sedgwick offers a comprehensive benefits package and opportunities for growth.

Qualifications

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

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.
• Coordinates vendor referrals for additional investigation and/or litigation management.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
• Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
• Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
• Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
• Ensures claim files are properly documented and claims coding is correct.
• Refers cases as appropriate to supervisor and management.
• Performs other duties as assigned.
• Supports the organization's quality program(s).
• Travels as required.

Education

Bachelor's degree from an accredited college or university preferred.

Job description

Sedgwick in Marlton, NJ is seeking a Liability Claims Examiner to adjudicate complex general liability, premise liability and litigated claims. The role involves investigating exposure, negotiating settlements, and managing reserves, with a hybrid schedule (2 days in-office) within commutable distance.

Ideal candidates have a Bachelor’s degree, 5 years of claims management experience, and relevant licensing. Sedgwick offers a comprehensive benefits package and opportunities for growth.