Remote PIP & Med Pay Claims Examiner – NJ Expert

Sedgwick; Jackson (MS); Remote; USD 75,000 - 85,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development and growth

Job summary

Sedgwick is seeking a Claims Examiner with PIP/Med Pay expertise to investigate, negotiate, and settle complex claims in a New Jersey context. You will guide insureds through the claims process, apply policy provisions, and coordinate with brokers and other professionals.

The role offers a flexible work schedule, strong growth opportunities, and a broad benefits package. Candidates with state licenses and relevant certifications are preferred.

Qualifications

• Six (6) years of related experience, including three (3) years of PIP/Med Pay adjusting experience.
• Bachelor's degree from an accredited college or university preferred.
• Professional certification and state adjusting licenses as applicable to line of business.

Responsibilities

• Manages PIP/Med Pay claims across multiple jurisdictions; NJ experience required.
• Investigates loss details, evaluates, negotiates, and resolves claims within authority guidelines.
• Reviews files and instructions, establishes reserves and issues payments.
• Documents thought processes, investigations, evaluations, negotiations, and settlements.
• Keeps insureds and claimants informed with timely status updates.
• Serves as a subject matter expert on state laws, regulations, and procedures.
• Delivers best-in-class service with proactive communications to customers, brokers, and adjusters.
• Works independently on higher-technical-complexity assignments and coordination.
• Identifies possibly suspicious claims and takes statements.
• Identifies coverage decisions on complex claims.

Skills

PIP/Med Pay

Investigation

Negotiation

Customer service

Education

Bachelor's degree

Professional certification

State adjusting licenses

Job description

Sedgwick is seeking a Claims Examiner with PIP/Med Pay expertise to investigate, negotiate, and settle complex claims in a New Jersey context. You will guide insureds through the claims process, apply policy provisions, and coordinate with brokers and other professionals.

The role offers a flexible work schedule, strong growth opportunities, and a broad benefits package. Candidates with state licenses and relevant certifications are preferred.