Claims Representative - Consumer

SedgwickSeven Hills, OH
Onsite

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

Requirements

  • Three (3) years of claims management experience or equivalent combination of experience and education required.
  • In-depth knowledge of first party property and casualty claim adjudication as applicable to line of business
  • Excellent oral and written communication, including presentation skills
  • PC literate, including Microsoft Office products
  • Excellent analytical and interpretive skills
  • Excellent organizational skills
  • Excellent interpersonal skills
  • Ability to work in a team environment
  • Ability to meet or exceed Performance Competencies

Nice To Haves

  • Bachelor's degree from and accredited college or university preferred.
  • Professional certification as applicable to line of business preferred.

Responsibilities

  • Manages first party property, casualty and/or medical reimbursement claims based on multiple/additional coverage and/or programs as defined by client-specific program.
  • Makes coverage determinations based on investigation/evaluation and communicates claim actions with claimant and client.
  • Adjudicates proper settlement up to designated authority level.
  • Works directly with underwriter/client on high value and complex cases.
  • Handles high volume of claims, phone calls and correspondence ensuring claim files are properly documented; meets quality and production goals; and meets customer guidelines and deadlines.
  • Performs other duties as assigned.
  • Supports the organization's quality program(s).
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