Agency Business Advisor
Farmers Insurance District 0420
Claims Adjuster – Liability
Sedgwick
full-time
Posted on:
Location Type: Hybrid
Location: Troy • Missouri • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- To analyze mid- and higher-level general liability claims to determine benefits due;
- To ensure ongoing adjudication of claims within company standards and industry best practices;
- Manage mid-level general liability claims by gathering information to determine liability exposure;
- Assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.
- Assess liability and resolve claims within evaluation.
- Approve and process assigned claims, determine benefits due, and manage action plan pursuant to the claim or client contract.
- Manage subrogation of claims and negotiate settlements.
- Communicate claim action with claimant and client.
- Ensure claim files are properly documented and claims coding is correct.
- May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
- Maintain professional client relationships.
- Perform other duties as assigned.
- Supports the organization's quality program(s).
Requirements
- Bachelor's degree from an accredited college or university preferred.
- Four (4) years of claims management experience or equivalent combination of education and experience required.
Benefits
- Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
- 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.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
claims managementliability assessmentclaims adjudicationclaims processingnegotiationsubrogationclaims codingmedical claims processingaction plan managementreserve valuation
Soft skills
communicationrelationship managementorganizational skillsanalytical skillsproblem-solving
Certifications
Bachelor's degree
