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Complex Claims Analyst

Job in Appleton, Outagamie County, Wisconsin, 54914, USA
Listing for: Sedgwick
Full Time position
Listed on 2026-08-30
Job specializations:
  • Insurance
    Insurance Claims, Risk Manager/Analyst, Insurance Analyst, Health Insurance
Salary/Wage Range or Industry Benchmark: 65000 - 95000 USD Yearly USD 65000.00 95000.00 YEAR
Job Description & How to Apply Below

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

Complex Claims AnalystARE YOU AN IDEAL CANDIDATE?

If you have five 5+ years of trucking/transportation and litigation claims experience and a strong background in complex liability claims, we would love to hear from you. The ideal candidate brings strong analytical skills, sound judgment, and the ability to navigate complex claim issues and drive effective resolutions.

PRIMARY PURPOSE OF

THE ROLE

To prospectively identify complex claims issues and complaints; to strategically triage referrals to the appropriate examiner or complex claims advisors for handling; or to independently handle and expedite resolution of less complex complaints and/or claim issues.

ESSENTIAL RESPONSIBILITIES MAY INCLUDE
  • Analyzes data to identify complex claims requiring further intervention through triaging internal referrals, complaints from regulatory agencies and external entities.
  • Proactively and strategically triages complex claim issues or complaints; determines the most appropriate resource to resolve.
  • Uses knowledge of all aspects of claims handling in evaluating the issue for expedited handling or assignment for continued handling.
  • Articulates and documents clear and concise file notes to allow stakeholders to understand the issue evaluation and determination.
  • Provides technical direction, feedback, and resolution on specified claims.
  • Performs other duties as assigned.
  • Supports the organization's quality program(s).
QUALIFICATIONS
  • Education & Licensing:
    Five (5) years of liability claims experience or equivalent combination of experience and education required.
  • Specific jurisdictional expertise preferred.
  • Bachelor's degree from an accredited college or university preferred. Industry designation(s) preferred. Licenses as required for specific jurisdictions.
Skills & Knowledge
  • Subject matter expertise in liability and transportation claims processing
  • Ability to obtain and maintain appropriate licensing
  • Ability to manage claims across multiple jurisdictions
  • Excellent oral and written communication skills
  • PC literate, including Microsoft Office products
  • Strong analytical and interpretive skills
  • Strong organizational skills
  • Strong time management skills
  • Excellent interpersonal skills
  • Ability to work in a team environment
  • Ability to meet or exceed Service Expectations
Work environment requirements include
  • Physical:
    Computer keyboarding
  • Auditory/visual:
    Hearing, vision and talking
  • Mental:
    Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.

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