Remote PIP Claims Examiner — Flexible Schedule

Sedgwick; Santa Fe (NM); On-site; USD 75,000 - 85,000; Full time

Benefits offered by this job

Medical, dental, vision

401K on day one

PTO

Flexible schedule

Referral incentive program

Job summary

Sedgwick is seeking a Claims Examiner for No Fault - PIP/Lit required in New York. The role involves investigating, negotiating, and resolving PIP/Med Pay claims across jurisdictions, inputting claim data, and guiding insureds through the process.

This position emphasizes independent work within authority limits, timely updates, and expertise in state laws to ensure proper handling of claims. Sedgwick offers a comprehensive benefits package and work-life balance.

Qualifications

• Six years of related experience, including three years in PIP/Med Pay adjusting.
• Bachelor's degree preferred.
• State adjusting licenses required or to be secured as applicable.

Responsibilities

• Manages PIP/Med Pay claims across multiple jurisdictions with appropriate authority.
• Investigates loss details, evaluates, negotiates, and resolves claims.
• Reviews files and establishes reserves, issues payments.
• Documents investigation, evaluation, negotiation, and settlement decisions.
• Provides timely claims status updates to insureds and brokers.
• Serves as SME on state laws, regulations, and procedures.

Skills

PIP/Med Pay adjusting

Claims investigation

Negotiation

Regulatory knowledge

Education

Bachelor's degree preferred

Job description

Sedgwick is seeking a Claims Examiner for No Fault - PIP/Lit required in New York. The role involves investigating, negotiating, and resolving PIP/Med Pay claims across jurisdictions, inputting claim data, and guiding insureds through the process.

This position emphasizes independent work within authority limits, timely updates, and expertise in state laws to ensure proper handling of claims. Sedgwick offers a comprehensive benefits package and work-life balance.