Role Description The Bodily Injury Claims Adjuster is responsible for the investigation, evaluation, and settlement of bodily injury liability claims. The right candidate must verify coverage, determine liability, maintain timely correspondence and determine the best course of action with medium levels of autonomy, while working closely with clients, claimants, and attorneys as an experienced claims professional. - Investigate new claims and initiate timely contacts with clients, claimants and legal counsel to determine appropriate actions to be taken. - Read and comprehend insurance policies. Properly evaluate liability, address time limit demands appropriately. - Communicate with injured individuals, their attorneys, healthcare providers, and other involved parties. - Negotiate settlements with claimants and attorneys and draw up contracts. - Report to clients and excess carrier requests regarding claim status and follow through on recommended actions. - Maintain detailed records of claims, including investigation findings, communication logs, and settlement details. - Prepare for and attend hearings or trials when necessary. - Remain in direct compliance with company policies and procedures, including MMSEA reporting. - Maintain active adjuster license in states where this is required. - Ability to utilize windows-based claims systems and Microsoft type applications. - Meet with clients and account management to conduct claim reviews, including account location visits to present cost reports, reserves, active claims and settlement recommendations. Qualifications - Working knowledge of insurance policies and legal procedures for claims in Kentucky. - Minimum of five (5) years of experience handling, negotiating, and settling complex bodily injury and liability claims, including litigation management and coordination with defense counsel, preferably within the State of Kentucky. - Ability to assess complex situations, evaluate evidence, and make informed decisions regarding liability and claim value. - Experience with medical terminology is essential. - Exceptional communication and interpersonal skills. - Confidence in negotiating settlements to reach mutually agreeable outcomes. - Detail-oriented with strong organizational and time management skills. - Excellent customer service and telephone skills. - Ability to work in a fast-paced environment and manage multiple claims while meeting deadlines. - College degree is preferred. - Continuing education and seminars related to changing claim laws. Benefits - Competitive salary commensurate with experience. - Excellent benefits including medical, dental, vision, disability, life insurance, and 401(K) with match. Values At Charles Taylor, our values define our identity, principles and conduct. This person will demonstrate and champion Charles Taylor Values by ensuring Agility, Integrity, Care, Accountability and Collaboration. Equal Opportunity Employer Here at Charles Taylor we are proud to be an Inclusive Employer. We provide an environment of mutual respect with zero tolerance to discrimination of any kind regardless of age, disability, gender identity, marital/family status, race, religion, sex, or sexual orientation. Our external partnerships and the dedicated work we do in promoting a transparent and fair recruitment and selection process all contribute to the successful, inclusive, and diverse culture and environment which we are proud to be a part of at Charles Taylor. Company Description Charles Taylor is an independent, global provider of claims solutions, insurance management services and technology platforms for all property and casualty markets, including commercial property, workers’ compensation, and auto/liability. We offer complex loss adjusting, technical services, third-party administration, and managed care programs with specialization in catastrophic, aviation, energy, and marine claims. With over 100 years of expertise at our core, we offer a comprehensive suite of solutions across all lines of business to help our clients manage risk.

Role Description Sie bearbeiten Schäden aus dem Bereich Sachversicherung (Wohngebäude, Hausrat). - Sie verantworten den gesamten Schadenabwicklungsprozess. - Sie kümmern sich u.a. um die Reduzierung der Schadenaufwendungen und die Durchführung von Regressen. Qualifications - Sie haben eine abgeschlossene Ausbildung oder Studium z.B. im Bereich Versicherungen und Finanzen, Jura/Recht, o.ä. - Sie bringen mehrjährige Berufserfahrung in der Schadenbearbeitung mit. Benefits - Flexible Arbeitszeiten - 100 % Homeoffice/ remote Work (deutschlandweit) - 30 Tage Urlaub - Betriebliche Altersvorsorge - Gruppenunfallversicherung - Möglichkeit zur Workation - Weiterbildungs- und Entwicklungsmöglichkeiten - Individuelle Einarbeitung - Möglichkeit zum Sabbatical - Firmenkreditkarte - Job-Rad - Firmenevents - Corporate Benefits Company Description PaKo Consulting ist ein spezialisierter Personalvermittler mit Sitz in Düsseldorf, der sich auf Vertriebspositionen konzentriert. Mit jahrelanger Erfahrung im Bereich der Personalvermittlung, bietet PaKo Consulting eine professionelle und persönliche Unterstützung bei der Karriereplanung seiner Klienten. - Der Ansatz von PaKo Consulting unterscheidet sich von anderen Personalvermittlern durch eine faire Zahlungsvereinbarung, eine diskrete und vertrauliche Zusammenarbeit sowie durch einen deutschlandweiten Suchprozess. - PaKo Consulting legt großen Wert darauf, die Bedürfnisse seiner Kunden und Kandidaten zu verstehen und individuelle Lösungen anzubieten. - Zu den Kernwerten des Unternehmens zählen Zuverlässigkeit, Ehrlichkeit, Engagement und Partnerschaft. - Das Team von PaKo Consulting besteht aus erfahrenen Fachleuten, die durch ihre Kompetenz und ihre persönliche Betreuung überzeugen.

Title: Workers Compensation Claims Examiner | West Hills, CA (Remote 3 Days) Location: West Hills, CA, United States Job Description: Full time job requisition id R70978 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 Workers Compensation Claims Examiner | West Hills, CA (Remote 3 Days) 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? - Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.  - Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.  - 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. OFFICE LOCATIONS: West Hills, CA (Agile) 3 days remote PRIMARY PURPOSE OF THE ROLE: To analyze Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. ESSENTIAL RESPONSIBLITIES MAY INCLUDE - Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.  - Negotiating settlement of claims within designated authority.  - Communicating claim activity and processing with the claimant and the client.  - Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner. QUALIFICATIONS Education & Licensing: 5 years of claims management experience or equivalent combination of education and experience required. - High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.  - Professional certification as applicable to line of business preferred. Licensing / Jurisdiction Knowledge: SIP required or must be obtained within one (1) year of employment; California workers compensation jurisdictional knowledge required. TAKING CARE OF YOU Flexible work schedule.  Referral incentive program.  Career development and promotional growth opportunities.  A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one. WORK ENVIRONMENT REQUIREMENTS INCLUDE 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 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 - $98,000. 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. #LI-Hybrid #claimsexaminer #hybrid #claims Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws. 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.

Role Description The Claims Examiners provide a service to our policyholders by reviewing claims to determine the validity of the insurance claim filed and identify the need for further investigations. Examiners resolve medical/dental/life/trip cancellation claims; documenting actions; maintaining their imaging queues; maintaining quality audit standards and ensuring their outcomes are following the Certificate of Insurance, Policy and Plan Documents as well as legal and regulatory agencies. Duties and Responsibilities - Determines covered insurance losses by studying provisions of policy or certificate. - Establishes proof of loss by studying proof of claim; assembling additional information as required from outside sources, including claimant, physician, employer, hospital, and other insurance companies; initiating or conducting investigation of questionable claims. - Documents medical claims actions by completing forms, reports, logs, and records. - Resolves claims by approving or denying documentation; calculating benefit due; initiating payment or composing denial letter. - Ensures legal compliance by following company policies, procedures, guidelines, as well as state and federal insurance regulations. - Maintains quality customer services by following core values. Qualifications - At least 1 year of prior medical claims processing experience OR willing to consider at least 2 years of experience with coding, billing, reviewing medical records, claims research, benefits review, medical office, or any other claims related role (i.e. complex claims, LCM claims, BI claims, P&C claims, etc.). - Knowledge of basic medical terminology. - Ability to read and interpret insurance policy/certificate wording. - Ability to research and logically consider details from multiple sources to analyze and make a determination of benefits within a productivity-based environment. - Computer skills and proficiency in operating common office equipment. - Documentation, Data Entry Skills. - High attention to detail with ability to analyze information and Problem-solving skills. - Proficiency with basic math. Preferred Skills - Knowledge of ICD-10. - Knowledge of FDA Health and HIPAA Regulations. Benefits - Comprehensive benefits package including Medical / RX / Dental / Vision / Life insurance. - 401k Plan with company match. - Paid Time Off and Company Paid Holidays. - Free employee parking. - On site fitness center. - Casual dress environment. - Tuition reimbursement plan.