Claims Examiner, BI- REMOTE (Commercial Trucking)
About the position 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. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Examiner, BI- REMOTE (Commercial Trucking) PRIMARY PURPOSE : To analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.
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.
- Performs other duties as assigned.
- Supports the organization's quality program(s).
- Travels as required.
Requirements
- 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.
- 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 arenaflex 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. Apply tot his job
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