# Claims Examiner, Auto | Bodily Injury **Company**: Sedgwick **Location**: Telecommuter FL **Experience**: senior **Job type**: full-time **Category**: Insurance **Industry**: Insurance **Apply**: https://sedgwick.wd1.myworkdayjobs.com/en-US/Sedgwick/job/Telecommuter-FL/Claims-Examiner--Auto---Bodily-Injury_R75110-1?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply **Canonical**: https://yubhub.co/jobs/job_adf6b801-a50 ## 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 | Bodily Injury, you will analyze complex or technically difficult auto and general liability claims to determine benefits due; work with high exposure claims involving litigation and rehabilitation; ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and identify subrogation of claims and negotiate settlements. **Responsibilities** - Analyze and process complex or technically difficult general liability claims by investigating and gathering information to determine the exposure on the claim; manage claims through well-developed action plans to an appropriate and timely resolution. - Assess liability and resolve claims within evaluation. - Negotiate settlement of claims within designated authority. - Calculate and assign timely and appropriate reserves to claims; manage reserve adequacy throughout the life of the claim. - Calculate and pay benefits due; approve and make timely claim payments and adjustments; and settle claims within designated authority level. - Prepare necessary state filings within statutory limits. - Manage the litigation process; ensure timely and cost-effective claims resolution. - Coordinate vendor referrals for additional investigation and/or litigation management. - Use appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients. - Manage claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. - Report claims to the excess carrier; respond to requests of directions in a professional and timely manner. - Communicate claim activity and processing with the claimant and the client; maintain professional client relationships. - Ensure claim files are properly documented and claims coding is correct. - Refer cases as appropriate to supervisor and management. - Perform other duties as assigned. - Support the organization's quality program(s). **Qualifications** - Education & Licensing: Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws. - Bachelor's degree from an accredited college or university preferred. - Professional certification as applicable to line of business preferred. - Skills: strong oral and written communication, including presentation skills, PC literate including Microsoft Office products, and ability to work in a team environment. - Secure and maintain the State adjusting licenses as required for the position. **Work Environment Requirements** - Physical: Computer keyboarding - Auditory/visual: Hearing, vision and talking - Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines. ## Skills ### Required - claims management - auto policies - coverage's - principles - laws - Microsoft Office products - communication - presentation skills ### Nice to have - professional certification - state adjusting licenses --- Source: [Apply at sedgwick.wd1.myworkdayjobs.com](https://sedgwick.wd1.myworkdayjobs.com/en-US/Sedgwick/job/Telecommuter-FL/Claims-Examiner--Auto---Bodily-Injury_R75110-1?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)