Claims Representative - Liability | General Liability | Multi State Jurisdiction | Licensing: Reciprocal Required - Remote

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?  

• Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. 

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:  To process low level general/product 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 FUNCTIONS and RESPONSIBILITIES

• Processes low level general/product 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.

• Performs other duties as assigned.

• Supports the organization's quality program(s).

• Travels as required.

QUALIFICATIONS

Education & Licensing: Bachelor's degree from an accredited college or university preferred.

Experience: 2 years of Liability claims management experience or equivalent combination of education and experience required.

Jurisdiction: Multi State

Licensing: Required, NY and Hawaii preferred

TAKING CARE OF YOU

• 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.

WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations. 

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

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (45,027.00 - 70,000.00 USD Annual). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.