Complex Claims Advisor; REMOTE - NC license
Fayetteville, Cumberland County, North Carolina, 28305, USA
Listed on 2026-01-06
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Insurance
Risk Manager/Analyst, Insurance Claims
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 Advisor (REMOTE - NC license & experience REQUIRED; some travel)
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.
We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
PRIMARY PURPOSETo develop targeted solutions and provide added technical guidance and oversight to ensure matters are resolved optimally while creating a culture of continual quality improvement designed to elevate the overall claim handling to benefit our stakeholders.
ESSENTIAL FUNCTIONS and RESPONSIBILITIESProactively and strategically manages a complex claim inventory by assessing complex claims issues, utilizing jurisdictional expertise to provide oversight, and directs the handling to achieve the best possible resolution.
Acts as the organizational subject matter expert for line of business and key jurisdictions on complex claim issues.
Uses knowledge of all aspects of claims handling in evaluating exposure; recommends and directs action plans for issue or case resolution.
Articulates and documents clear and concise file notes to allow stakeholders to understand the issues and path to resolution.
Facilitates round tables with groups/teams; engages appropriate internal and external resources as needed.
Provides technical leadership on and maintains co-ownership of complex claim issues; through further influence creates a culture of continual quality improvement.
Performs other duties as assigned.
Supports the organization's quality program(s).
Travels as required.
Bachelor's degree from an accredited college or university preferred. Industry designation(s) preferred. Licenses as required for specific jurisdictions.
ExperienceEight (8) years of casualty claims experience or equivalent combination of education and experience required to include three (3) to five (5) years of experience handling complex claims and experience in negotiation, mediation, arbitration or ADR skills on higher value complex claims. Supervisory experience a plus. Specific jurisdictional expertise preferred.
TAKING CARE OF YOUFlexible 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.
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…
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