Auto​/Property Claims Representative - Consumer

Auto/Property Claims Representative - Consumer

Primary

Purpose:

To analyze reports claims, determine benefits due and make timely payments and adjustments; to make timely payments and adjustments for specified program claims including high value and complex claims; to coordinate investigative efforts; to thoroughly review contested claims; to negotiate settlement of claims up to the designated authority level; and to provide superior customer services.

Essential Functions and Responsibilities

• Manages first party property, casualty and/or medical reimbursement claims based on multiple/additional coverage and/or programs as defined by client-specific program.
• Makes coverage determinations based on investigation/evaluation and communicates claim actions with claimant and client.
• Adjudicates proper settlement up to designated authority level.
• Works directly with underwriter/client on high value and complex cases.
• Handles high volume of claims, phone calls and correspondence ensuring claim files are properly documented; meets quality and production goals; and meets customer guidelines and deadlines.

Additional Functions and Responsibilities

• Performs other duties as assigned.
• Supports the organization's quality program(s).

Qualifications

Licensing Requirements

Candidates should possess an active Property & Casualty Adjuster License for states where licensing is required. Multiple state adjuster licenses are strongly preferred and will be considered a significant advantage.

Preferred Experience

We are seeking candidates with demonstrated experience handling ongoing property claims in a structured claims environment. Candidates with a proven track record of long-term engagement in desk-adjusting or staff-adjusting roles are preferred. Experience managing claims through the full claim lifecycle, maintaining productivity standards, and working within established processes is highly desirable.

Education & Licensing Bachelor's degree from and accredited college or university preferred. Professional certification as applicable to line of business preferred.

Experience Three (3) years of claims management experience or equivalent combination of experience and education required.

Skills & Knowledge

• In-depth knowledge of first party property and casualty claim adjudication as applicable to line of business
• Excellent oral and written communication, including presentation skills
• PC literate, including Microsoft Office products
• Excellent analytical and interpretive skills
• Excellent organizational skills
• Excellent interpersonal skills
• Ability to work in a team environment
• Ability to meet or exceed Performance Competencies

Work Environment When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental:
Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical:
Computer keyboarding, travel as required

Auditory/Visual:
Hearing, vision and talking

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.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of a specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $48,000 salary.

A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

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

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.