Claims Representative - Liability - Irving or Plano, TX

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?  

• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. 
• Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights. 
• Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. 
• Enjoy flexibility and autonomy in your daily work, your location, and your career path. 
• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. 

ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

PRIMARY PURPOSE OF THE ROLE: To process low level general liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision.

ESSENTIAL RESPONSIBILITIES MAY INCLUDE:

• Processes low 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.
• Develops and coordinates low level general liability claims' action plans to resolution, return-to-work efforts, and approves claim payments.
• Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
• Administers 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 low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
• Maintains professional client relationships.

QUALIFICATIONS AND LICENSING

Education/Experience
Bachelor's degree from an accredited college or university preferred.

Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.

TAKING CARE OF YOU

• Flexible Work Schedule
• Referral Incentive Program
• Opportunity to work from home
• Career development and promotional growth opportunities
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day 1