Claims Adjuster - Liability, GL, BI, Auto, PD
Sedgwick
full-time
Posted on:
Location Type: Hybrid
Location: Irving • Texas • United States
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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.
- Manages 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.
- Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
- Manages subrogation of claims and negotiates settlements.
- Communicates claim action with claimant and client.
- Ensures 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.
Requirements
- Bachelor's degree from an accredited college or university preferred.
- Licenses as required.
- Professional certifications as applicable to line of business preferred.
- Four (4) years of claims management experience or equivalent combination of education and experience required.
Benefits
- Flexible work schedule.
- Referral incentive program.
- Career development and promotional growth opportunities.
- A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
claims analysisclaims adjudicationsubrogationnegotiationclaims managementclaims processingclaims codingmedical claims processingliability determinationreserve valuation
Soft skills
communicationnegotiation skillsorganizational skillsattention to detailproblem-solving
Certifications
professional certifications