Insurance Verification Representative
Huron
Claims Adjuster – Liability
Sedgwick
full-time
Posted on:
Location: Iowa • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Analyze mid- and higher-level general liability claims to determine benefits due
- Ensure ongoing adjudication of claims within company standards and industry best practices
- Identify subrogation of claims and negotiate settlements
- Gather information to determine liability exposure; assign reserve values to claims
- Make claims payments as necessary and settle claims up to designated authority level
- Approve and process assigned claims, determine benefits due, and manage action plan pursuant to the claim or client contract
- 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 including state and physician filings and decisions on appropriate treatments recommended by utilization review
- Maintain professional client relationships
Requirements
- Bachelor\u2019s degree from an accredited college or university preferred
- Four (4) years of claims management experience or equivalent combination of education and experience required
- Ability to manage mid- and higher-level general liability claims
- Experience assessing liability exposure, assigning reserve values, and settling claims up to designated authority
- Experience with subrogation and negotiating settlements
- Ability to maintain professional client relationships
