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, determine benefits due, and manage high-exposure claims involving litigation and rehabilitation. The role ensures claims are handled in accordance with service expectations, industry best practices, and client requirements, and includes identifying subrogation opportunities and negotiating settlements. The position is based in Marlton, New Jersey, with a hybrid schedule of two days in the office for candidates within commuting distance. Remote work is available to candidates outside commuting distance. The role requires knowledge of East Coast jurisdictions, specifically New Jersey, Pennsylvania, and Florida. A home-state license is preferred. Sedgwick describes its workplace as a caring culture centered on empathy, accountability, collaboration, growth, and inclusion. The company offers flexibility, professional 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, specifically New Jersey, Pennsylvania, and Florida.
- Ability to think clearly and conceptually and demonstrate judgment, troubleshooting, problem-solving, analytical skills, and discretion.
- Ability to handle work-related stress, manage multiple priorities simultaneously, and meet deadlines.
- Ability to perform computer keyboarding and meet the role's hearing, vision, and speaking requirements.
Nice To Haves
- Bachelor's degree from an accredited college or university.
- Professional certification applicable to the line of business.
- Home-state license.
Responsibilities
- Investigate and gather information to assess exposure on complex or technically difficult general liability claims, and manage claims through action plans to timely and appropriate resolution.
- Assess liability and resolve claims within the evaluation.
- Negotiate claim settlements within designated authority.
- Calculate and assign timely, appropriate reserves and manage reserve adequacy throughout the claim.
- 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 the litigation process to support timely and cost-effective claim resolution.
- Coordinate vendor referrals for additional investigation and litigation management.
- Use cost-containment techniques, including strategic vendor partnerships, to reduce claim costs for clients.
- Manage claim recoveries, including subrogation, Second Injury Fund excess recoveries, and Social Security and Medicare offsets.
- Report claims to excess carriers and respond professionally and promptly to requests for direction.
- Communicate claim activity and processing with claimants and clients and maintain professional client relationships.
- Ensure claim files are properly documented and claim coding is correct.
- Refer cases to a supervisor or management when appropriate.
- Support the organization's quality programs.
- Travel as required.
- Perform other duties as assigned.
Benefits
- Flexible work schedule.
- Referral incentive program.
- Career development and promotional growth opportunities.
- Medical insurance.
- Dental insurance.
- Vision insurance.
- 401(k) plan with matching.
- Paid time off.
- Disability insurance.
- Life insurance.
- Employee assistance.
- Flexible spending account or health savings account.
- Additional voluntary benefits.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
