Claims Examiner - Liability | GL Litigation | REMOTE

Claims Examiner – General Liability & GL Litigation (Remote)

We are looking for driven individuals that embody our caring counts model and core values, including empathy, accountability, collaboration, growth, and inclusion. The role involves analyzing claims on behalf of our valued clients to determine benefits due while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

• Analyze and process claims through well‑developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiate settlement of claims within designated authority.
• Communicate claim activity and processing with the claimant and the client.
• Report claims to the excess carrier and respond to requests for directions in a professional and timely manner.
• Act as subject‑matter expert on appropriate insurance principles and laws for the line of business, including recoveries, offsets, deductions, claim and disability duration, cost‑containment principles such as medical management practices, and Social Security and Medicare application procedures.
• Review, understand, and interpret contracts.

• 4+ years of claims management experience or an equivalent combination of education and experience.
• High School Diploma or GED required;
  Bachelor’s degree preferred.
• Professional certification relevant to the line of business preferred.
• Home State license and the ability to obtain New York licensing is required.

• Competitive pay range: $63,000 to $88,765 (based on skill set, experience level, and location).
• Comprehensive benefits package including medical, dental, vision, 401(k) with matching, PTO, disability and life insurance, employee assistance, and flexible spending or health savings accounts.
• Flexible work schedule and remote work options.
• Referral incentive program and opportunities for career development and promotional growth.
• Agile work environment and professional development resources.

• Physical:
  Computer keyboarding.
• Auditory/visual:
  Hearing, vision, and talking.
• Mental:
  Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.

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