Liability Claims Examiner | General Liability, Premise Liability & Litigation Experience | Jurisdictions: East Coast | Licensing: Preferred
About The Position
Sedgwick is seeking a Liability Claims Examiner to analyze and adjudicate complex general liability, premises liability, and litigated claims. The role involves determining benefits and exposure, managing claims through timely resolution, negotiating settlements, and ensuring that claims are handled in accordance with service expectations, industry best practices, and client requirements. The position covers East Coast jurisdictions, with a focus on New Jersey, Pennsylvania, and Florida. The role is based in Marlton, New Jersey, with a hybrid schedule requiring two days in the office for candidates within commuting distance. Remote work is available for candidates outside commuting distance. The position may require travel. Sedgwick describes its culture as caring and collaborative and offers flexibility, career development, and a comprehensive benefits package.
Requirements
- Five years of claims management experience, or an equivalent combination of education and experience.
- Knowledge of East Coast jurisdictions, particularly New Jersey, Pennsylvania, and Florida.
Nice To Haves
- Bachelor's degree from an accredited college or university.
- Professional certification applicable to the line of business.
- Home-state licensing.
Responsibilities
- Investigate and gather information to assess exposure on complex or technically difficult general liability claims, and manage claims through action plans to timely resolution.
- Assess liability and resolve claims within evaluation parameters.
- Negotiate claim settlements within designated authority.
- Calculate and assign timely, appropriate reserves and manage reserve adequacy throughout the claim lifecycle.
- Calculate and pay benefits, approve and make timely claim payments and adjustments, and settle claims within designated authority.
- Prepare necessary state filings within statutory limits.
- Manage litigation and pursue timely, cost-effective claim resolution.
- Coordinate vendor referrals for additional investigation or litigation management.
- Use cost-containment techniques, including strategic vendor partnerships, to reduce claim costs.
- Manage recoveries, including subrogation, Second Injury Fund excess recoveries, and Social Security and Medicare offsets.
- Report claims to excess carriers and respond to their requests and directions professionally and promptly.
- Communicate claim activity and processing with claimants and 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.
- Support the organization's quality programs and perform other assigned duties.
- Travel as required.
Benefits
- Flexible work schedule.
- Referral incentive program.
- Career development and promotional growth opportunities.
- Medical, dental, and vision coverage.
- 401(k) and matching.
- Paid time off.
- Disability and life insurance.
- Employee assistance.
- Flexible spending or health savings account.
- Additional voluntary benefits.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
