Liability Claims Adjuster

About the role

Join Sedgwick, a company dedicated to helping people facing unexpected challenges. Our 33,000 colleagues strive to make a positive impact every day. We offer a supportive culture and a balanced work-life environment where you can grow your career.

Primary Purpose

To analyze mid- and higher-level general liability claims, determine benefits due, ensure claims are adjudicated within company standards and industry best practices, and identify and negotiate subrogation settlements.

Essential Functions and Responsibilities

• Manages mid-level general liability claims by gathering information to determine liability exposure; assigns reserve values to claims, makes claims payments as necessary, and settles claims up to designated authority level.
• Affirms liability and resolves claims within evaluation.
• Approves and processes assigned claims, determines benefits due, and manages action plans according to the claim or client contract.
• Manages subrogation of claims and negotiates settlements.
• Communicates claim actions with claimants and clients.
• Maintains proper documentation of claim files and ensures claims coding accuracy.
• Maintains professional client relationships.

Additional Functions and Responsibilities

• Supports the organization's quality programs.
• Travels as required.

Qualifications

• Education & Licensing: Bachelor's degree from an accredited college or university preferred.
• Experience: 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.
• Communication: Excellent oral and written communication, including presentation skills.
• Technical Skills: PC literate, including Microsoft Office products.
• Interpersonal Skills: 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.

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 and Benefits

The range of starting pay for this role is $61,857.00 - $86,600. 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.