Remote PIP/Med Pay Claims Specialist — NJ Expert

Sedgwick; Augusta (ME); On-site; USD 75,000 - 85,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentive program

Career development & growth

Job summary

Sedgwick, a global leader in claims administration, seeks a seasoned Claims Examiner to investigate, negotiate, and resolve PIP and Med Pay claims, applying policy provisions and jurisdictional requirements. You will guide insureds and claimants through the claims process and options.

In New Jersey, you will evaluate loss details, establish reserves, document decision-making, and deliver timely updates. Sedgwick offers flexible schedules, a competitive benefits package, and opportunities for

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 required.

Responsibilities

• Manages claims and adjusts moderately complex to complex PIP/Med Pay claims across multiple jurisdictions; must have New Jersey claims experience.
• Investigates loss details, evaluates, negotiates, and resolves claims within authority guidelines; maintains productivity and confidentiality.
• Reviews assigned files and claim instructions for proper handling; establishes reserves and issues payment.
• Clearly documents thought process, investigation, evaluation, negotiation, and settlement decisions.
• Delivers best in class claim service through proactive communications with customers, brokers, and other professionals.
• Identifies possibly suspicious claims and takes recorded statements.

Skills

PIP/Med Pay adjusting experience

New Jersey claims experience

Negotiation

Education

Bachelor's degree preferred

Professional certification preferred

State adjusting licenses

Job description

Sedgwick, a global leader in claims administration, seeks a seasoned Claims Examiner to investigate, negotiate, and resolve PIP and Med Pay claims, applying policy provisions and jurisdictional requirements. You will guide insureds and claimants through the claims process and options.

In New Jersey, you will evaluate loss details, establish reserves, document decision-making, and deliver timely updates. Sedgwick offers flexible schedules, a competitive benefits package, and opportunities for