Claims Examiner | Auto NF, PIP, MP | Remote

About the position 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 Claims Examiner | Auto NF, PIP, MP | Remote 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? Enjoy flexibility and autonomy in your daily work, your location, and your career path. This role is open to a remote, telecommuter, work-at-home, or hybrid setting nationwide. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. ARE YOU AN IDEAL CANDIDATE? As a Claims Examiner, you will primarily handle auto-related liability claims for the following lines of coverage: Auto Liability, No Fault (NF), Personal Injury Protection (PIP), and Medical Payments (MP). No two days are the same as you assist our clients with their claims! If you are an agile auto claims examiner with 5+ years of experience, we want to talk to you! PRIMARY PURPOSE OF THE ROLE To analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.

Responsibilities

• Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly.
• Responsible for litigation process on litigated claims.
• Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims.
• Reports large claims to excess carrier(s).
• Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.
• Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage.
• Communicates claim action/processing with insured, client, and agent or broker when appropriate.
• Performs other duties as assigned.
• Supports the organization's quality program(s).
• Travels as required.

Requirements

• Bachelor's degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• Secure and maintain the State adjusting licenses as required for the position.
• Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage’s, principles, and laws
• In-depth knowledge of personal and commercial line auto policies, coverage’s, principles, and laws
• Knowledge of medical terminology for claim evaluation and Medicare compliance
• Knowledge of appropriate application for deductibles, sub-limits, SIR’s, carrier and large deductible programs.
• Strong oral and written communication, including presentation skills
• PC literate, including Microsoft Office products
• Strong organizational skills
• Strong interpersonal skills
• Good negotiation skills
• Ability to work in a team environment
• Ability to meet or exceed Service Expectations
• Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
• Computer keyboarding, travel as required
• Hearing, vision and talking

Benefits

• medical
• dental
• vision
• 401k and matching
• PTO
• disability and life insurance
• employee assistance
• flexible spending or health savings account
• other additional voluntary benefits

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