General Liability Adjuster

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.

As a General Liability Adjuster, your primary purpose will be to analyze mid- and higher-level general liability claims to determine benefits due, ensure ongoing adjudication of claims within company standards and industry best practices, and identify subrogation of claims and negotiate settlements.

Responsibilities:

• Manage mid-level general liability claims by gathering information to determine liability exposure, assign reserve values to claims, make claims payments as necessary, and settle claims up to designated authority level.
• Assess liability and resolve claims within evaluation.
• Approve and process assigned claims, determine benefits due, and manage action plan pursuant to the claim or client contract.
• Manage subrogation of claims and negotiate settlements.
• Communicate claim action with claimant and client.
• Ensure claim files are properly documented and claims coding is correct.
• May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
• Maintain professional client relationships.

Additional Responsibilities:

• Perform other duties as assigned.
• Support the organization's quality program(s).
• Travel as required.

Qualifications:

• Bachelor's degree from an accredited college or university preferred.
• NY license required.
• Four (4) years of claims management experience or equivalent combination of education and experience required.

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 line-of-business.
• Excellent oral and written communication, including presentation skills.
• PC literate, including Microsoft Office products.
• Analytical and interpretive skills.
• Strong organizational skills.
• Good interpersonal skills.
• Excellent negotiation skills.
• Ability to work in a team environment.
• Ability to meet or exceed Service Expectations.