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General Liability Claims Examiner

Job in San Diego, San Diego County, California, 92189, USA
Listing for: Sedgwick Claims Management Services Ltd
Full Time position
Listed on 2026-01-13
Job specializations:
  • Insurance
    Insurance Claims, Risk Manager/Analyst, Insurance Analyst
Salary/Wage Range or Industry Benchmark: 75000 - 90000 USD Yearly USD 75000.00 90000.00 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 General Liability Claims Examiner
* 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 PURPOSE**:
To analyze complex or technically difficult general liability and auto 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 FUNCTIONS and RESPONSIBILITIES
*** Analyzes and processes complex or technically difficult general liability and auto 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.
** QUALIFICATION
* *** Education & Licensing
** Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.
** Experience
* * Five (5) years of General Liability claims management experience or equivalent combination of education and experience required.
** TAKING CARE OF YOU
*** Referral incentive program.
* Career development and promotional growth opportunities.
* A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
* As required by law, Sedgwick provides a reasonable range of compensation for roles that…
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