Claim Examiner l Liability l Jurisdication Northeast States l Eden Prairie, MN preferred OR Remote

Sedgwick • Houston, TX • 6h ago

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

Claim Examiner l Liability l Jurisdication Northeast States l Eden Prairie, MN preferred OR Remote

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?

Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights.

Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.

Enjoy flexibility and autonomy in your daily work, your location, and your career path.

Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

PRIMARY PURPOSE OF THE ROLE : To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.

ESSENTIAL RESPONSIBILITIES MAY INCLUDE:

Analyzes and processes complex or technically difficult general liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.

Assesses liability and resolves claims within evaluation.

Negotiates settlement of claims within designated authority.

Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.

Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.

Prepares necessary state fillings within statutory limits.

Manages the litigation process; ensures timely and cost effective claims resolution.

Coordinates vendor referrals for additional investigation and/or litigation management.

Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.

Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.

Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.

Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.

Ensures claim files are properly documented and claims coding is correct.

Refers cases as appropriate to supervisor and management.

Performs other duties as assigned.

Supports the organization's quality program(s).

Travels as required.

QUALIFICATIONS & LICENSING

Education & Experience

Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.

Experience

Five (5) years of claims management experience or equivalent combination of education and experience required.

TAKING CARE OF YOU

Flexible Work Schedule

Referral Incentive Program

Opportunity to work from home

Career development and promotional growth opportunities

A diverse and comprehensive benefits offering including medical, dental vision, 401K on day 1

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ($66,000 - $85,000). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see sedgwick.com

Similar Jobs

Advanced Diagnostic Radiologic Technologist (Computed Tomography)

Veterans Affairs, Veterans Health Administration • Houston, TX • 4h ago

Hospital & Medical

Summary The Advanced Diagnostic Radiologic Technologist (DRT), Computed Tomography (CT), is assigned to the Michael E. DeBakey, VA Medical Center (MEDVAMC), Radiology Service, Computed Tomography section. The Advanced Di...

4h ago

Go to Apply

Account Executive Team Leader

AON • Houston, TX • 5h ago

Retail & Hospitality

Account Executive III & Team Leader, Energy - Houston, TX Are you looking to lead an industry-leading team and deliver innovative, effective solutions to Energy clients? If so, join Aon's Energy Practice in Houston,...

5h ago

Go to Apply

Account Executive VA & Private Pay Sales

Elara Caring • Pasadena, TX • 5h ago

Sales & Marketing

At Elara Caring, we have a unique opportunity to play a huge role in the growth of an entire home care industry. Here, each employee has the chance to make a real difference by carrying out our mission every day. Join ou...

5h ago

Go to Apply

Sales and Service Associate

24 Hour Fitness, INC. • Houston, TX • 6h ago

Management & Administrative

FULL-TIME Part-time LOCATION 11528 Gulf Freeway Houston TX 77034 Who we are At 24 Hour Fitness, we are dedicated to our mission of creating a healthier, happier world. We are passionate about providing a fitness communit...

6h ago

Go to Apply

Sales and Service Associate

24 Hour Fitness, INC. • Houston, TX • 6h ago

Management & Administrative

FULL-TIME Part-time LOCATION 1513 West 18th Street Houston TX 77008 Who we are At 24 Hour Fitness, we are dedicated to our mission of creating a healthier, happier world. We are passionate about providing a fitness commu...

6h ago

Go to Apply

Sales and Service Associate

24 Hour Fitness, INC. • Spring, TX • 6h ago

Management & Administrative

FULL-TIME Part-time LOCATION 1000 Lake Plaza Drive Spring TX 77389 Who we are At 24 Hour Fitness, we are dedicated to our mission of creating a healthier, happier world. We are passionate about providing a fitness commun...

6h ago

Go to Apply

Sales and Service Associate

24 Hour Fitness, INC. • Pearland, TX • 6h ago

Management & Administrative

FULL-TIME Part-time LOCATION 10011 Broadway Street Pearland TX 77584 Who we are At 24 Hour Fitness, we are dedicated to our mission of creating a healthier, happier world. We are passionate about providing a fitness comm...

6h ago

Go to Apply

Electric Motor Mechanic

Integrated Power Services • La Porte, TX • 6h ago

Manufacturing & Warehouse

About the Job At IPS, we're all about exceptional service and exceptional people. We're looking for a passionate In-Shop Technician who loves hands-on work, takes pride in their craft, and wants to have a meaningful impa...

6h ago

Go to Apply

Electrical Designer

Actalent • Houston, TX • 6h ago

IT & Engineering

Job Title: Electrical Designer Job Description We are seeking a motivated Junior CAD Electrical Designer to join our engineering team. In this role, you will be responsible for developing and updating electrical schemati...

6h ago

Go to Apply

Asst Engineering Technician - Electrical Substation Drafter

System One • Houston, TX • 6h ago

Hospital & Medical

Job Title: Assistant Engineering Technician - Electrical Substation Drafter Location: Overland Park, KS Job Type: Contract-to-Hire opportunity Compensation: $28.00 - $32.50 per hour Work Model: 100% Onsite Openings: 3 Po...

6h ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.