The 'Apply with SEEK' option will be utilized for International applicants, mainly Australia. If this does not apply to you please use the 'Apply' option.Auto Bodily Injury Claims ExaminerIF YOU CARE, THERE’S A PLACE FOR YOU HEREFor a career path that is both challenging and rewarding, join Sedgwick’s talented team of 27,000 colleagues around the globe. Sedgwick is a leading provider of technology-enabled risk, benefits and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. Whether they have a workplace injury, suffer property or financial loss or damage from a natural or manmade disaster, are involved in an auto or other type of accident, or need time away from work for the birth of a child or another medical situation, we are here to provide compassionate care and expert guidance. Our clients depend on our talented colleagues to take care of their most valuable assets—their employees, their customers and their property. At Sedgwick, caring counts®. Join our team of creative and caring people of all backgrounds, and help us make a difference in the lives of others.PRIMARY PURPOSE : To analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.ESSENTIAL FUNCTIONS and RESPONSIBILITIESProcesses 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.
ADDITIONAL FUNCTIONS and RESPONSIBILITIESPerforms other duties as assigned.
Supports the organization's quality program(s).
Travels as required.
QUALIFICATIONSEducation & LicensingBachelor'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.ExperiencePrior commercial or trucking experience required.Skills & KnowledgeIn-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
WORK ENVIRONMENTWhen applicable and appropriate, consideration will be given to reasonable accommodations.Mental: 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 deadlinesPhysical: Computer keyboarding, travel as requiredAuditory/Visual: Hearing, vision and talkingNOTE : Credit security clearance, confirmed via a background credit check, is required for this position.The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.at any time.Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
Claims Examiner - Auto Bodily Injury (Remote Opportunity)