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Claims Associate - Liability

Role overview

Summary

This role is for a Claims Associate focused on analyzing lower-level general liability claims at Sedgwick. You will support the adjudication process and maintain client relationships while ensuring compliance with company standards.

Qualifications

  • High school diploma or GED.
  • One (1) year of general office experience or equivalent combination of education and experience.
  • Excellent oral and written communication skills.
  • PC literate, including Microsoft Office products.
  • Strong organizational skills.

Responsibilities

  • Analyze reported lower-level general liability claims to determine benefits due.
  • Process general liability claims, determining compensability and benefits due.
  • Communicate claim action and processing with claimants, clients, and medical contacts.
  • Maintain professional client relationships.

Key facts

Hard skills

Other skills

  • Microsoft Office
  • Analytical Skills
  • Organizational Skills
  • Social Skills
  • Communication
  • Teamwork
  • Problem Solving
  • Time Management

About the company

Sedgwick Ireland logo

Sedgwick Ireland

  • Insurance
  • Startup
  • 201–500
Sedgwick, previously operating under the OSG Vericlaim brand, is Ireland's largest and longest established Specialist Third Party Administrator and Loss Adjuster. We are a SEDGWICK Company and part of the Global Sedgwick Organisation backed by the resources of the Leading Global Provider of technology enabled risk and claims solutions we can truly offer a local market based service operating to market leading international standards. Having built on our history and heritage as Chartered Loss Adjusters, today we provide a diverse and extensive range of outsource services for the Insurance and Financial Sectors in Ireland and Internationally. A unique business model incorporating industry and market experience, the application of behavioural science, lean process management and modern technology sets Sedgwick apart from the competition in our chosen markets. Providing the service layer between our clients and their customers we have a proven pedigree and reputation for operational excellence delivering the widest range of specialist and technical services in the market. The Sedgwick difference is our People and a desire to develop our talent for the benefit of all our stakeholders. Taking Care of People "Caring Counts” is at the heart of everything we do and the guiding principal in the development of Sedgwick becoming the leading broad based service provider we are today. We are Regulated as an Insurance Intermediary with the Central Bank of Ireland, have full EU Passport status and meet all Fiduciary and Corporate Governance Standards.

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Job description

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Claims Associate - LiabilityPRIMARY PURPOSE: To analyze reported lower-level level general liability claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES• Handles lower-level liability and/or physical damage claims under close supervision.
• Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.
• Processes general liability claims determining compensability and benefits due; monitors reserve accuracy, and files necessary documentation with state agency.
• Communicates claim action/processing with claimant, client and appropriate medical contact.
• Ensures claim files are properly documented and claims coding is correct.
• May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.
• Maintains professional client relationships.ADDITIONAL FUNCTIONS and RESPONSIBILITIES• Performs other duties as assigned.
• Supports the organization's quality program(s).QUALIFICATIONEducation & Licensing
High school diploma or GED required. Licenses as required.
Experience
One (1) year of general office experience or equivalent combination of education and experience required. Claims industry experience preferred.Skills & Knowledge• Excellent oral and written communication skills
• PC literate, including Microsoft Office products
• Analytical and interpretive skills
• Strong organizational skills
• Good interpersonal skills
• Ability to work in a team environment
• Ability to meet or exceed Performance CompetenciesWORK 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

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Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

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.

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