Complex Claims Analyst

About the role

Joining Sedgwick means becoming part of a meaningful mission where 33,000 colleagues worldwide support people through unexpected challenges. At Sedgwick, we foster growth, embrace a caring culture, and prioritize work-life balance. Our goal is to help you reach your full potential.

Primary Purpose

To analyze mid- and higher-level general auto claims, determine scope of damages, ensure claims adjudication within company standards and industry best practices, identify subrogation opportunities, and negotiate settlements.

Essential Functions

• Manages mid-level and higher-level auto commercial and personal lines claims by gathering information to determine exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.
• Affirms liability and resolves claims within evaluation.
• Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
• Manages subrogation of claims and negotiates settlements.
• Communicates claim actions with claimants and clients.
• Maintains professional client relationships.

Additional Functions

• Performs other duties as assigned.
• Travels 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.
• 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 as applicable to line-of-business.
• Excellent oral and written communication skills, including presentation skills.
• PC literate, including Microsoft Office products.
• Analytical and interpretive skills.
• Strong organizational skills.
• Excellent interpersonal skills.
• Excellent negotiating skills.
• Ability to create and complete comprehensive, accurate and constructive written reports.
• Ability to work in a team environment.
• Ability to meet or exceed Performance Competencies.

Work Environment

• 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.

Pay & Benefits

The starting pay range for this role is $50,000 - $62,000 USD annually. A comprehensive benefits package is offered, including medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.