• Responsible for the accurate and timely processing of medical, dental, vision and prescription drug claims. • Provide courteous and prompt responses to customer inquiries. • Communicate professionally with peers, supervisors, subordinates, vendors, customers, and the public. • Verifies the accuracy and receipt of all required documentation for each claim submitted. • Collaborates with providers, plan participants, other claims payers, or any other party necessary to obtain information necessary to accurately process a claim. • Analyzes information necessary for processing. • Assures that the system processes the claim correctly and determines payment according to the plan as written. • Answers telephone calls from plan participants, group contacts, and customer service representatives pertaining to benefits and claims inquiries. • Resolves problematic claims with the assistance of the Team Leader, Claims Manager and/or the Director of Claims. • Assigns critically ill patients to large case management. • Assists other examiners as needed due to workload requirements, including assigned back-up when examiners are absent. • Aids the Team Leader and/or the Claims Manager in the resolution of claim appeals and disputes by providing documentation for review. • Researches, calculates and requests refunds when necessary. • Contributes to the daily workflow with regular and punctual attendance. • Thoroughly researches and completes renewal reports in a timely manner in consultation with the Marketing Department. • Process eligible claims on groups before the end of their stoploss contract renewal period. • Assists the Legal Department with subrogation claims as necessary. • Attends various group meetings as required. • Assists with audits as needed. • Assists with plan benefit set-up and changes as needed.

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, Auto | Bodily Injury | Remote 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. ESSENTIAL 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. QUALIFICATIONS 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. Experience 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. Skills & 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 WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations. 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 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 $80,000 to $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. Always accepting applications. 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. 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.

• Analyze and process complex auto and commercial trucking transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages. • Process complex auto commercial trucking and personal line claims, including bodily injury and ensure claim files are properly documented and coded correctly. • Responsible for litigation process on litigated claims. • Coordinate vendor management, including the use of independent adjusters to assist the investigation of claims. • Report large claims to excess carrier(s). • Develop and maintain action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution. • Identify and pursue subrogation and risk transfer opportunities; secure and dispose of salvage. • Communicate claim action/processing with insured, client, and agent or broker when appropriate.

National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers’ evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers. Job Description Responsible for investigating and confirming the facts of loss for advanced automobile accidents. Determines coverage, liability, damages and otherwise adjusts and negotiates claims within limit of authority. Every claim presents a new challenge. This role is ideal for someone who enjoys problem-solving, analyzing information, and making confident decisions while supporting customers and internal partners. Key Responsibilities • Applies increased experience in the Adjuster II level or a rotation into a specialty position (Coverage, Investigation Specialist, Total Loss, Initial Handler, Extended Handler, etc.) • For claims involving injuries (if handled), learns how to review, evaluate, and negotiate basic to moderate injury claims • Handles investigation regarding all aspects of advanced auto claims (coverage, liability and damages) with the exercise discretion and independence within increased level of authority • Recognizes and identifies body parts of a vehicle and understanding other potential property damage • Identifies customer needs and works to meet those needs using appropriate customer service skills • Determines subrogation or fraud potential and how to handle • Applies advanced understanding of insurance policies written by the company, the industry, and organizational relationships within the company and department Supervisory Responsibilities • This job does not have supervisory duties. Skills Case Management, Claims Administration, Claims Resolution, Claims Review, Insurance Claims Investigations Compensation Base compensation offered for this role is: Adjuster Analyst III: $21.20 -- $30.87/hr Adjuster Consultant I: $26.49 -- $37.50/hr Adjuster Consultant II: $28.03 -- $39.42/hr Adjuster Sr Consultant I: $35.82 -- $45.58/hr Compensation is based on experience and qualifications. Total compensation for this role is comprised of several factors, including the base compensation outlined above, plus incentive pay (i.e. commission, bonus, etc.) if applicable for the role. Joining our team isn’t just a job — it’s an opportunity. One that takes your skills and pushes them to the next level. One that encourages you to challenge the status quo. One where you can shape the future of protection while supporting causes that mean the most to you. Joining our team means being part of something bigger – a winning team making a meaningful impact. Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component. For jobs in San Francisco, please click “here” for information regarding the San Francisco Fair Chance Ordinance. For jobs in Los Angeles, please click “here” for information regarding the Los Angeles Fair Chance Initiative for Hiring Ordinance. To view the “EEO Know Your Rights” poster click “here”. This poster provides information concerning the laws and procedures for filing complaints of violations of the laws with the Office of Federal Contract Compliance Programs. To view the FMLA poster, click “here”. This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling employees how to file a complaint. It is the Company’s policy to employ the best qualified individuals available for all jobs. Therefore, any discriminatory action taken on account of an employee’s ancestry, age, color, disability, genetic information, gender, gender identity, gender expression, sexual and reproductive health decision, marital status, medical condition, military or veteran status, national origin, race (include traits historically associated with race, including, but not limited to, hair texture and protective hairstyles), religion (including religious dress), sex, or sexual orientation that adversely affects an employee's terms or conditions of employment is prohibited. This policy applies to all aspects of the employment relationship, including, but not limited to, hiring, training, salary administration, promotion, job assignment, benefits, discipline, and separation of employment. National General Holdings Corp., a member of the Allstate family of companies, is headquartered in New York City. National General traces its roots to 1939, has a financial strength rating of A– (excellent) from A.M. Best, and provides personal and commercial automobile, homeowners, umbrella, recreational vehicle, motorcycle, supplemental health, and other niche insurance products. We are a specialty personal lines insurance holding company. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products. Companies & Partners Direct General Auto & Life, Personal Express Insurance, Century-National Insurance, ABC Insurance Agencies, NatGen Preferred, NatGen Premier, Seattle Specialty, National General Lender Services, ARS, RAC Insurance Partners, Mountain Valley Indemnity, New Jersey Skylands, Adirondack Insurance Exchange, VelaPoint, Quotit, HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star Marketing, Euro Accident. Benefits National General Holdings Corp. is an Equal Opportunity (EO) employer – Veterans/Disabled and other protected categories. All qualified applicants will receive consideration for employment regardless of any characteristic protected by law. Candidates must possess authorization to work in the United States, as it is not our practice to sponsor individuals for work visas. In the event you need assistance or accommodation in completing your online application, please contact NGIC main office by phone at (336) 435-2000.