About the position
At Sedgwick, we prioritize taking care of our colleagues, ensuring that they have the support they need to thrive both personally and professionally. As an Auto Claims Examiner, you will play a crucial role in analyzing and processing complex auto and commercial transportation claims. This position involves reviewing coverage, conducting thorough investigations, determining liability, and evaluating the scope of damages. You will be responsible for managing both commercial and personal line claims, including bodily injury, ensuring that all claim files are meticulously documented and coded correctly. In this role, you will also oversee the litigation process for litigated claims and coordinate vendor management, which includes working with independent adjusters to assist in the investigation of claims. You will report large claims to excess carriers and develop action plans to ensure compliance with state-required contact deadlines, facilitating prompt and appropriate resolution of claims. Identifying and pursuing subrogation and risk transfer opportunities will be part of your responsibilities, as well as securing and disposing of salvage. Effective communication with insured parties, clients, and agents or brokers will be essential to keep all stakeholders informed about claim actions and processing. This position is a temporary assignment and offers the flexibility to work remotely, allowing you to balance your professional responsibilities with personal commitments. Sedgwick is committed to fostering a culture of caring, where diversity is celebrated, and every colleague is valued. If you are driven to make a difference and enjoy a challenge, this is the perfect opportunity for you to contribute to a meaningful cause while growing your career.
Responsibilities
- Processes 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.
- Performs other duties as assigned.
- Supports the organization's quality program(s).
- Travels as required.
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 to include in-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws.
- Professional certification as applicable to line of business preferred.
- Secure and maintain the State adjusting licenses as required for the position.
- 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
- Medical insurance
- Dental insurance
- Vision insurance
- 401k and matching
- Paid Time Off (PTO)
- Disability insurance
- Life insurance
- Employee assistance programs
- Flexible spending account or health savings account
- Additional voluntary benefits
