Remote Liability Claims Examiner – General & Premises

Sedgwick; Buffalo (NY); Ibrido; USD 85.000 - 90.000; Tempo pieno

Descrizione del lavoro

Sedgwick is seeking a Liability Claims Examiner to adjudicate general liability, premise liability andlitigation-related claims. The role emphasizes analyzing complex claims, negotiating settlements, and managing reserves and litigation in a hybrid Marlton, NJ environment.

Open to remote if commutable distance is unlikely; the jurisdiction focus covers East Coast states including NJ, PA and FL, with a comprehensive benefits package and growth opportunities within a global leader in claims

Competenze

• Bachelor's degree from an accredited college or university preferred.
• Five (5) years of claims management experience or equivalent combination of education and experience required.

Mansioni

• 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.

Formazione

Bachelor's degree

Descrizione del lavoro

Sedgwick is seeking a Liability Claims Examiner to adjudicate general liability, premise liability andlitigation-related claims. The role emphasizes analyzing complex claims, negotiating settlements, and managing reserves and litigation in a hybrid Marlton, NJ environment.

Open to remote if commutable distance is unlikely; the jurisdiction focus covers East Coast states including NJ, PA and FL, with a comprehensive benefits package and growth opportunities within a global leader in claims