Claims Examiner | General Liability BI | Captive | Remote

Sedgwick • Austin, TX

122d • $85,000 - $100,000

About The Position

As a Claims Examiner at Sedgwick, you’ll have the opportunity to take on new challenges and help solve complex problems. Enjoy flexibility and autonomy in your daily work and your career path. This is a remote, work-at-home, telecommuter position. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

Requirements

• Bachelor's degree from an accredited college or university preferred.
• Five (5) years of claims management experience or equivalent combination of education and experience required.
• Subject matter expert of appropriate insurance principles and laws for line-of-business handled.
• Excellent oral and written communication, including presentation skills.
• PC literate, including Microsoft Office products.
• Analytical and interpretive skills.
• Strong organizational skills.
• Good interpersonal skills.
• Excellent negotiation skills.
• Ability to work in a team environment.
• Ability to meet or exceed Service Expectations.

Nice To Haves

• Professional certification as applicable to line of business preferred.

Responsibilities

• Analyzes and processes complex or technically difficult general liability claims by investigating and gathering information to determine the exposure on the claim.
• Manages claims through well-developed action plans to an appropriate and timely resolution.
• Assesses liability and resolves claims within evaluation.
• Negotiates settlement of claims within designated authority.
• Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
• Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles claims within designated authority level.
• Prepares necessary state fillings within statutory limits.
• Manages the litigation process; ensures timely and cost effective claims resolution.
• Coordinates vendor referrals for additional investigation and/or litigation management.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
• Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
• Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
• Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
• Ensures claim files are properly documented and claims coding is correct.
• Refers cases as appropriate to supervisor and management.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• 401k and matching
• PTO
• Disability insurance
• Life insurance
• Employee assistance program
• Flexible spending or health savings account
• Other additional voluntary benefits

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees