Claims Examiner, Bodily Injury
Sedgwick
full-time
Posted on:
Location Type: Remote
Location: Remote • Louisiana, Oklahoma, Texas, Utah, Wisconsin • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages
- Process 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
- Coordinate vendor management, including the use of independent adjusters to assist 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 and risk transfer opportunities; secure and dispose of salvage
- Communicate claim action/processing with insured, client, and agent or broker when appropriate
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
- 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
Benefits
- Flexible work arrangements
- Professional development opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
claims managementinvestigationsliability determinationsubrogationrisk transfersalvage disposalmedical terminologydeductibles applicationcoverage evaluationlitigation process
Soft skills
oral communicationwritten communicationpresentation skillsorganizational skillsinterpersonal skillsnegotiation skillsteamworkservice expectations
Certifications
Bachelor's degree