Remote PIP Claims Examiner | NJ Expertise & Growth

Sedgwick; Olympia (WA); On-site; USD 75,000 - 85,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

Medical, dental, vision, 401K on day 1

Job summary

Sedgwick is seeking a Claims Examiner focused on PIP/Med Pay to investigate, negotiate, and resolve claims across jurisdictions with emphasis on New Jersey. This role inputs data, guides insureds, and applies policy provisions with accuracy and care.

The ideal candidate has six years of related experience, including three in PIP/Med Pay, and maintains necessary state licenses. A comprehensive benefits package and growth opportunities are offered.

Qualifications

• Six years of related experience, including three years in PIP/Med Pay adjusting.
• Bachelor's degree preferred; professional certification may apply.
• Maintain the state adjusting licenses as required for the position.

Responsibilities

• Manage PIP/Med Pay claims across jurisdictions—NJ experience preferred.
• Investigate loss details, evaluate, negotiate, and resolve claims within authority.
• Review files and issue payments based on claim details and damages.
• Document thought processes, investigations, evaluation, negotiations, and settlements clearly.
• Prioritize claims workload and provide timely status updates to policyholders.
• Serve as SME on state laws, regulations, and procedures for proper handling.
• Deliver best-in-class service with proactive communications to customers and brokers.
• Identify potentially suspicious claims and take recorded statements.
• Identify, confirm, and make coverage decisions on complex claims.

Skills

PIP/Med Pay adjusting

Claims investigation

Negotiation

State law knowledge

Education

Bachelor's degree preferred

Professional certification preferred

State adjusting licenses required

Job description

Sedgwick is seeking a Claims Examiner focused on PIP/Med Pay to investigate, negotiate, and resolve claims across jurisdictions with emphasis on New Jersey. This role inputs data, guides insureds, and applies policy provisions with accuracy and care.

The ideal candidate has six years of related experience, including three in PIP/Med Pay, and maintains necessary state licenses. A comprehensive benefits package and growth opportunities are offered.