Environmental Claims Advisor

Sedgwick

About The Position

The Environmental Claims Advisor analyzes and manages complex or technically difficult environmental and liability claims, including claims involving severe injuries. The role coordinates case management in accordance with company standards, industry best practices, and client service requirements, and manages total claim costs while providing a high level of customer service. The advisor investigates claims, evaluates exposure and insurance coverage, develops and executes action plans for timely resolution, negotiates settlements within designated authority, and monitors reserves. The role also coordinates legal defense, identifies cost-containment and recovery opportunities, represents the company in legal proceedings as needed, maintains client relationships, and ensures accurate documentation and coding. The position may include delegating work and mentoring assigned staff.

Requirements

Eight years of claims management experience or an equivalent combination of education and experience.
In-depth knowledge of environmental liability insurance principles and applicable laws for the relevant line of business.
Knowledge of recoveries, offsets and deductions, claim duration, cost-containment principles, and applicable procedures.
Excellent oral and written communication skills, including presentation skills.
Computer literacy, including Microsoft Office products.
Analytical and interpretive skills.
Strong organizational skills.
Excellent negotiation skills.
Good interpersonal skills.
Ability to work in a team environment.
Ability to meet or exceed Performance Competencies.
Ability to perform computer keyboarding and meet the role’s auditory, visual, and communication requirements.
Clear and conceptual thinking, excellent judgment and discretion, and ability to meet deadlines.

Nice To Haves

Bachelor’s degree from an accredited college or university.
Professional certification applicable to the line of business.

Responsibilities

Analyze and process complex or technically difficult environmental liability claims by investigating and gathering information to determine claim exposure.
Manage claims through well-developed action plans to achieve appropriate and timely resolution.
Conduct or assign full investigations and prepare investigation reports concerning new events, claims, and legal actions.
Analyze complex liability insurance coverage and policies.
Negotiate claim settlements up to the designated authority level.
Calculate and assign timely, appropriate reserves and monitor reserve adequacy throughout the claim lifecycle.
Recommend settlement strategies and bring forward structured settlement proposals when appropriate.
Coordinate legal defense by assigning attorneys, supporting investigations, reviewing attorney invoices, and monitoring counsel compliance with client guidelines.
Use cost-containment techniques, including strategic vendor partnerships, to reduce clients’ overall claim costs.
Identify and investigate possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim costs.
Represent the company in depositions and mediations and monitor trials as needed.
Communicate claim activity and processing to clients and maintain professional client relationships.
Ensure claim files are properly documented and claims coding is correct.
Refer cases to supervisors and management as appropriate.
Delegate work and mentor assigned staff.
Support the organization’s quality programs.
Perform other duties as assigned.