Claims Examiner l Liability l Jurisdiction Louisiana l reside in Louisiana

Position: Claims Examiner l Liability l Jurisdiction Louisiana l Must reside in Louisiana
Location: Louisiana

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 Claims Examiner l Liability l Jurisdiction Louisiana l Must reside in Louisiana
* 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.

We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
** PRIMARY PURPOSE OF

THE ROLE **:
To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.
** ESSENTIAL RESPONSIBILITIES MAY INCLUDE:
*** Analyzes and processes complex or technically difficult general liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
* Assesses liability and resolves claims within evaluation.
* Negotiates settlement of claims within designated authority.
* Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
* Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
* Prepares necessary state fillings within statutory limits.
* Manages the litigation process; ensures timely and cost effective claims resolution.
* Coordinates vendor referrals for additional investigation and/or litigation management.
* Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
* Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
* Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
* Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
* Ensures claim files are properly documented and claims coding is correct.
* Refers cases as appropriate to supervisor and management.
* Performs other duties as assigned.
* Supports the organization's quality program(s).
* Travels as required.
** QUALIFICATIONS & LICENSING
**** Education & Experience
** Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.
** Experience
* * Five (5) years of claims management experience or equivalent combination of education and experience required.
** TAKING CARE OF YOU
*** Flexible Work Schedule
* Referral Incentive Program
* Opportunity to work from home
* Career development and promotional growth opportunities
* A diverse and comprehensive benefits offering including medical, dental vision, 401K on day 1
* 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…