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.
As a Claims Examiner - Auto, your primary purpose will be to analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability, and evaluating the scope of damages.
Responsibilities
- Process complex auto commercial and personal line claims, including bodily injury, and ensure claim files are properly documented and coded correctly.
- Be responsible for the litigation process on litigated claims.
- Coordinate vendor management, including the use of independent adjusters to assist in the investigation of claims.
- Report large claims to excess carrier(s).
- Develop and maintain action plans to ensure state-required contact deadlines are met and to move the file towards prompt and appropriate resolution.
- Identify and pursue subrogation and risk transfer opportunities; secure and dispose of salvage.
- Communicate claim action/processing with insured, client, and agent or broker when appropriate.
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.
- 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, including in-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws.
Skills & Knowledge
- In-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws.
- Knowledge of medical terminology for claim evaluation and Medicare compliance.
- Knowledge of appropriate application for deductibles, sub-limits, SIR's, carrier and large deductible programs.
- Strong oral and written communication, including presentation skills.
- 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.