Claims Representative - Liability | General Liability | Multi State Jurisdiction | Licensing: R

Claims Representative
- Liability

Title:

Claims Representative
- Liability | General Liability | Multi State Jurisdiction | Licensing:
Reciprocal Required
- Remote

Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.

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

To process low level general/product liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision.

• Processes low level general/product liability claims by gathering information to determine liability exposure; assigns reserve values to claims, makes claims payments as necessary, and settles claims up to designated authority level.
• Develops and coordinates low level general liability claims' action plans to resolution, return-to-work efforts, and approves claim payments.
• Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
• Administers subrogation of claims and negotiates settlements.
• Communicates claim action with claimant and client.
• Ensures claim files are properly documented and claims coding is correct.
• May process low‑level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
• Maintains professional client relationships.
• Performs other duties as assigned.
• Supports the organization’s quality program(s).
• Travels as required.

Education & Licensing: Bachelor's degree from an accredited college or university preferred.

Experience: 2 years of Liability claims management experience or equivalent combination of education and experience required.

Jurisdiction: Multi State

Licensing: Required, NY and Hawaii preferred.

• Flexible 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.

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

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 specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (45,027.

USD Annual). 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.