Remote PIP/Med Pay Claims Examiner — NJ Specialist

Sedgwick; Madison (WI); On-site; USD 75,000 - 85,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Career development

Benefits from day one

Job summary

Sedgwick is seeking a Claims Examiner with PIP/Med Pay expertise to investigate, negotiate, and resolve personal injury protection claims. You will input claim data, guide insureds through the process, and ensure compliant handling across jurisdictions.

This role requires 6+ years of related experience including 3+ years in PIP/Med Pay adjusting, a bachelor's degree (preferred), and state adjusting licenses. A competitive compensation package and benefits are offered.

Qualifications

• Six (6) years of related experience, to include three (3) years of PIP/Med Pay adjusting experience, or equivalent combination of education and experience.
• Bachelor's degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• Secure and maintain the State adjusting licenses as required for the position.

Responsibilities

• Investigates, negotiates, and resolves PIP/Med Pay claims in accordance with policy provisions and jurisdictional requirements.
• Input claim data and guide insureds and claimants through the claim process and options.
• Reviews assigned files and claim instructions for proper handling; establishes reserves and issues payment based on claim details.
• Clearly documents thought process, investigation, evaluation, negotiation, and settlement decisions.
• Delivers best in class claim service with proactive communications to customers, brokers, and other claim professionals.
• Works independently within significant limits on higher technical complexity and coordination.
• Identifies possibly suspicious claims and takes statements; makes coverage decisions on complex claims.

Skills

PIP/Med Pay adjusting

Education

Bachelor's degree preferred

State adjusting licenses

Professional certification

Job description

Sedgwick is seeking a Claims Examiner with PIP/Med Pay expertise to investigate, negotiate, and resolve personal injury protection claims. You will input claim data, guide insureds through the process, and ensure compliant handling across jurisdictions.

This role requires 6+ years of related experience including 3+ years in PIP/Med Pay adjusting, a bachelor's degree (preferred), and state adjusting licenses. A competitive compensation package and benefits are offered.