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Sedgwick

Sedgwick, headquartered in Memphis, Tennessee, provides a global clientele with technology-enabled risk and benefits solutions. Distinguished as an Employer of

Claims Examiner, Bodily Injury

Location

Wisconsin

Posted

110 days ago

Salary

$70K - $75K / year

Seniority

Senior

Bachelor Degree5 yrs expEnglish

Job Description

Claims Examiner, Bodily Injury

Sedgwick

• 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 claims within designated authority level • Prepares necessary state filings 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

Job Requirements

  • Bachelor's degree from an accredited college or university preferred
  • Professional certification as applicable to line of business preferred
  • Five (5) years of claims management experience or equivalent combination of education and experience required.

Benefits

  • medical
  • dental
  • vision
  • 401k and matching
  • PTO
  • disability and life insurance
  • employee assistance
  • flexible spending or health savings account
  • other additional voluntary benefits

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