Claims Representative - Consumer

About the role

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.

Responsibilities

• Manages first party property, casualty and/or medical reimbursement claims based on multiple/additional coverage and/or programs as defined by client-specific program.
• Makes coverage determinations based on investigation/evaluation and communicates claim actions with claimant and client.
• Adjudicates proper settlement up to designated authority level.
• Works directly with underwriter/client on high value and complex cases.
• Handles high volume of claims, phone calls and correspondence ensuring claim files are properly documented; meets quality and production goals; and meets customer guidelines and deadlines.
• Performs other duties as assigned.
• Supports the organization's quality program(s).

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• Three (3) years of claims management experience or equivalent combination of experience and education required.

Skills & Knowledge

• In-depth knowledge of first party property and casualty claim adjudication as applicable to line of business.
• Excellent oral and written communication, including presentation skills.
• PC literate, including Microsoft Office products.
• Excellent analytical and interpretive skills.
• Excellent organizational skills.
• Excellent interpersonal skills.
• Ability to work in a team environment.
• Ability to meet or exceed Performance Competencies.

Work 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.