Claims Examiner- General Liability (Remote)
Posted on: November 25, 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- General Liability (Remote)
**PRIMARY PURPOSE** : To analyze complex or technically difficult
general liability claims to determine benefits and/or to analyze
and process complex auto and commercial transportation claims by
reviewing coverage, completing investigations, determining
liability and evaluating the scope of damages.
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ Processes complex general liability claims by investigating and
gathering information to determine the exposure on the claim and/or
auto commercial and personal line claims, including bodily injury
and ensures claim files are properly documented and coded
+ 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
+ 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.
+ Assesses liability and resolves claims within evaluation.
+ Negotiates settlement of claims within designated authority.
+ Calculates and assigns timely and appropriate reserves to claims;
manages reserve adequacy throughout the life of the claim.
+ Calculates and pays benefits due; approves and makes timely claim
payments and adjustments; and settles clams within designated
+ Prepares necessary state fillings within statutory limits.
+ Manages the litigation process; ensures timely and cost effective
+ Coordinates vendor referrals for additional investigation and/or
+ Uses appropriate cost containment techniques including strategic
vendor partnerships to reduce overall cost of claims for our
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
+ Supports the organization's quality program(s).
+ Travels as required.
**Education & Licensing**
Bachelor's degree from an accredited college or university
preferred. Professional certification as applicable to line of
business preferred. Secure and maintain the State adjusting
licenses as required for the position.
Five (5) years of claims management experience or equivalent
combination of education and experience required to include
in-depth knowledge of general liability and/or personal and
commercial line auto policies, coverage's, principles, and
**Skills & Knowledge**
+ Subject matter expert of appropriate insurance principles and
laws for line-of-business handled, recoveries offsets and
deductions, claim and disability duration, cost containment
principles including medical management practices and Social
Security and Medicare application procedures as applicable to
+ In-depth knowledge of personal and commercial line auto policies,
coverage's, principles, and laws
+ Knowledge of medical terminology for claim evaluation and
+ Knowledge of appropriate application for deductibles, sub-limits,
SIR's, carrier and large deductible programs.
+ Strong oral and written communication, including presentation
+ 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
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
**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.
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
Keywords: Sedgwick, Boise , Claims Examiner- General Liability (Remote), Other , Boise, Idaho
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