Claims Examiner, Bodily Injury | Liability | Remote

Sedgwick•Seven Hills, OH

11d•$65,000•Remote

About The Position

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Examiner, Bodily Injury | Liability | Remote PRIMARY PURPOSE : To analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.

Requirements

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.
Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage’s, principles, and laws.
In-depth knowledge of personal and commercial line auto policies, coverage’s, principles, and laws
Knowledge of medical terminology for claim evaluation and Medicare compliance
Knowledge of appropriate application for deductibles, sub-limits, SIR’s, carrier and large deductible programs.
Strong oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Strong organizational skills
Strong interpersonal skills
Good negotiation skills
Ability to work in a team environment
Ability to meet or exceed Service Expectations

Responsibilities

Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly.
Responsible for litigation process on litigated claims.
Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims.
Reports large claims to excess carrier(s).
Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.
Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage.
Communicates claim action/processing with insured, client, and agent or broker when appropriate.
Performs other duties as assigned.
Supports the organization's quality program(s).
Travels as required.