Claims Examiner - Liability Bodily Injury
Location: Virginia Beach
Posted on: September 18, 2022
The 'Apply with SEEK' option will be utilized for International
applicants, mainly Australia. If this does not apply to you please
use the 'Apply' option.
Taking care of people is at the heart of everything we do, and we
start by taking care of you, our valued colleague. A career at
Sedgwick means experiencing our culture of caring. It means having
flexibility and time for all the things that are important to you.
It's an opportunity to do something meaningful, each and every day.
It's having support for your mental, physical, financial and
professional needs. It means sharpening your skills and growing
your career. And it means working in an environment that celebrates
diversity and is fair and inclusive.
A career at Sedgwick is where passion meets purpose to make a
positive impact on the world through the people and organizations
we serve. If you are someone who is driven to make a difference,
who enjoys a challenge and above all, if you're someone who cares,
there's a place for you here. Join us and contribute to Sedgwick
being a great place to work.
Great Place to Work -
Most Loved Workplace -
Forbes Best-in-State Employer
Claims Examiner - Liability Bodily Injury
***Remote from anywhere within the U.S. NY adjuster's license is
preferred, but not required.***
PRIMARY PURPOSE: To analyze reports claims, determine benefits due
and make timely payments and adjustments to complex program claims;
to coordinate investigative efforts; to thoroughly review contested
claims and negotiate settlement of claims up to the designated
authority level; to assist with assignment of daily workflow; to
assist with training and deployment of changes in client
instructions; and to provide superior customer services.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
- Analyzes and manages third party property, casualty and/or
medical reimbursement claims based on multiple/additional coverage
and/or programs as defined by client-specific program.
- Makes coverage determinations based on investigation/evaluation
and communicates claim actions with claimant and client.
- Adjudicates proper settlements up to designated authority
- Works directly with underwriter/client on high value complex
- Handles high volume of claims, phone calls and correspondence
ensuring claim files are properly documented; and meets
quality/production goals and customer guidelines and
- Communicates claim activity process with client and claimant as
- Assists with assignment of daily workflow in the department and
client data tracking system.
- Assists with coaching, training and deployment of changes in
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
- Performs other duties as assigned.
- Supports the organization's quality program(s).
Education & Licensing
Bachelor's degree from and accredited college or university
preferred. Professional certification as applicable to line of
business preferred. Licenses as required.
Four (4) years of claims management experience or equivalent
combination of experience and education required.
Skills & Knowledge
- In-depth knowledge of third party property, casualty, and/or
medical reimbursement claims adjudication as applicable to line of
- Superior oral and written communication, including presentation
- PC literate, including Microsoft Office products
- Superior analytical and interpretive skills
- Superior organizational skills
- Superior interpersonal skills
- Ability to work in a team environment
- Ability to meet or exceed Performance Competencies
When applicable and appropriate, consideration will be given to
Mental: Clear and conceptual thinking ability; excellent judgment,
troubleshooting, problem solving, analysis, and discretion; ability
to handle work-related stress; ability to handle multiple
priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
NOTE: Credit security clearance, confirmed via a background credit
check, is required for this position.
The statements contained in this document are intended to describe
the general nature and level of work being performed by a colleague
assigned to this description. They are not intended to constitute a
comprehensive list of functions, duties, or local variances.
Management retains the discretion to add or to change the duties of
the position at any time.
Sedgwick is an Equal Opportunity Employer and a Drug-Free
If you're excited about this role but your experience doesn't align
perfectly with every qualification in the job description, consider
applying for it anyway! Sedgwick is building a diverse, equitable,
and inclusive workplace and recognizes that each person possesses a
unique combination of skills, knowledge, and experience. You may be
just the right candidate for this or other roles.
Keywords: Sedgwick, Virginia Beach , Claims Examiner - Liability Bodily Injury, Other , Virginia Beach, Virginia
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