Claims Examiner, Pooling (Remote)
About the position At Sedgwick, taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring, which includes flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful every day, with support for your mental, physical, financial, and professional needs. You will have the chance to sharpen your skills and grow your career in an environment that celebrates diversity and is fair and inclusive. This role is a Claims Examiner position within our Pooling division, and it is open to a remote, telecommute, work-at-home setting. As a claims professional adjuster, you will be responsible for investigating, documenting, reviewing coverages, obtaining details, determining if there is coverage, submitting coverage analysis for review by the regional office, retaining counsel when necessary, entering payments, drafting denial letters, and pursuing subrogation actions. This desk adjuster role requires a proactive approach to claims management, ensuring that all claims are handled efficiently and effectively. You will be part of a rapidly growing, industry-leading global company known for its excellence and customer service. Enjoy flexibility and autonomy in your daily work, your location, and your career path. Leverage Sedgwick's broad, global network of experts to both learn from and share your insights. Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. If you are someone who is driven to make a difference, enjoys a challenge, and cares about the work you do, there is a place for you here at Sedgwick.
Responsibilities
- Analyze, investigate, evaluate, and adjust personal, commercial line, and/or public entity property and injury claims. ,
- Process complex commercial and personal line property claims, ensuring claim files are properly documented and coded correctly. ,
- Manage the litigation process on litigated claims. ,
- Coordinate vendor management, including the use of independent adjusters to assist in the investigation of claims. ,
- Report large claims to excess carrier(s). ,
- Develop and maintain action plans to ensure state-required contact deadlines are met and to move the file towards prompt and appropriate resolution. ,
- Identify and pursue subrogation opportunities; secure and dispose of salvage. ,
- Communicate claim action/processing with insured, client, and agent or broker when appropriate. ,
- Travel as required.
Requirements
- Bachelor's degree from an accredited college or university preferred. ,
- Five (5) years of claims management experience or equivalent combination of education and experience required. ,
- Knowledge of construction basics and property estimating software. ,
- In-depth knowledge of personal and commercial lines property policies, coverages, principles, and laws. ,
- Strong oral and written communication skills, including presentation skills. ,
- PC literate, including Microsoft Office products. ,
- Strong organizational skills and interpersonal skills. ,
- Good negotiation skills. ,
- Ability to work in a team environment. ,
- Ability to meet or exceed Performance Competencies. Nice-to-haves
- Professional certification as applicable to line of business preferred. ,
- Experience in public entity or commercial property claims handling.
Benefits
- Medical insurance ,
- Dental insurance ,
- Vision insurance ,
- 401k and matching ,
- Paid time off (PTO) ,
- Disability insurance ,
- Life insurance ,
- Employee assistance program ,
- Flexible spending account or health savings account ,
- Other additional voluntary benefits Apply Job! Apply tot his job
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