Senior Claims Examiner - Dedicated

Sedgwick • West Des Moines, IA

13d

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 Senior Claims Examiner - Dedicated Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands? Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights. Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. Enjoy flexibility and autonomy in your daily work, your location, and your career path. Access diverse and comprehensive benefits to take care of your mental, physical, financial, and professional needs. ARE YOU AN IDEAL CANDIDATE? To address and handle high end cases with serious injuries, complex coverage scenarios and legal inquiries or disputes; to develop a strategy to bring a case to satisfactory resolution. PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

Requirements

• Bachelor's degree from an accredited college or university preferred.
• Juris Doctorate (JD) preferred.
• Ten (10) years of experience handling litigation including 5 years of claims management experience or equivalent combination of education and experience required.

Responsibilities

• Reviews/acts on reports/forms; responds to inquiries; seeks legal opinion and early resolution; and communicates resolution to appropriate parties.
• Handles high end cases with serious injuries and/or complex coverage scenarios.
• Responds to decisions, agreement, and/or court order; creates action plan; determines need for examination; gains client authorization.
• Identifies cases for settlements/redemptions.
• Gathers/documents additional information and coordinates with client designees.
• Requests legal/private investigation; assigns to and coordinates with local counsel; monitors local counsel performance.
• Responds to plaintiff's counsel, union, employee, or client requests.
• Identifies issues and formulates defense strategy.
• Establishes/adjusts accrued liability and approves administrative expenses.
• Identifies subrogation opportunities and manages process.
• Attends and participates in mediations, trials, arbitrations or hearings as needed.
• Works with partners to affect early return-to-work.
• Performs other duties as assigned.
• Supports the organization's quality program(s).

Benefits

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior