Claims Examiner - Auto

• Here, there’s no limit to what you can achieve.
• To analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.

About Sedgwick

• 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.

Responsibilities

• FUNCTIONS and RESPONSIBILITIES Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly.
• Responsible for litigation process on litigated claims.
• Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims.
• Reports large claims to excess carrier(s).
• Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.
• Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage.
• Communicates claim action/processing with insured, client, and agent or broker when appropriate.
• ADDITIONAL FUNCTIONS and RESPONSIBILITIES Performs other duties as assigned.
• Supports the organization's quality program(s).
• Travels as required.

Requirements

• Education & Licensing 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 to include in-depth knowledge of personal and commercial line auto policies, coverage’s, principles, and laws.
• & 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 The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. at any time.