Claims Examiner | Auto NF, PIP, MP | Remote

2 weeks ago


Honolulu, United States Remote Staffing Full time

Claims Examiner | Auto NF, PIP, MP | RemoteBy 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.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? Enjoy flexibility and autonomy in your daily work, your location, and your career path. This role is open to a remote, telecommuter, work-at-home, or hybrid setting nationwide. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. Access diverse and comprehensive benefits to take care of your mental, physical, financial, and professional needs.Are You An Ideal Candidate?As a Claims Examiner, you will primarily handle auto-related liability claims for the following lines of coverage: Auto Liability, No Fault (NF), Personal Injury Protection (PIP), and Medical Payments (MP). No two days are the same as you assist our clients with their claims If you are an agile auto claims examiner with 5+ years of experience, we want to talk to youPrimary Purpose Of The RoleTo 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 ResponsibilitiesProcesses 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 ResponsibilitiesPerforms other duties as assigned.Supports the organization's quality program(s).Travels as required.QualificationsEducation & LicensingBachelor'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.ExperienceFive (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 & KnowledgeIn-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 EnvironmentWhen 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 $78,951 $87,428 USD annual salary. 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. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.



  • Honolulu, United States Hawaii Staffing Full time

    Claims Examiner | Auto NF, PIP, MP | RemoteBy 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...


  • Honolulu, United States Remote Staffing Full time

    Auto Liability Bodily Injury Claims Team LeadBy 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...


  • Honolulu, United States Sedgwick Full time

    A leading risk and claims administration company is seeking a Claims Examiner to handle complex auto-related liability claims. This role requires 5+ years of claims management experience and offers flexible remote work options. Responsibilities include analyzing claims, managing litigation, and coordinating investigations with vendors. A bachelor's degree is...


  • Honolulu, United States Hawaii Staffing Full time

    Auto Liability Bodily Injury Claims Team LeadBy 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...


  • Honolulu, United States Sedgwick Full time

    PRIMARY PURPOSE To analyze and process low to mid-level auto and transportation claims. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES Processes auto property damage regarding PIP and lower level injury claims; assesses damage, makes payments, and ensures claim files are properly documented and correctly coded based on the policy. Develops and maintains action...


  • Honolulu, United States Remote Staffing Full time

    Auto Property Damage Claims Team LeadBy 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....


  • Honolulu, HI, United States Sedgwick Full time

    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...


  • Honolulu, HI, United States Sedgwick Full time

    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...


  • Honolulu, United States Sedgwick Full time

    A global risk and claims administration leader is seeking a Claims Examiner to handle auto-related liability claims. This role offers flexibility in remote work and requires 5+ years of relevant experience. Ideal candidates will be skilled in managing complex claims and displaying strong organizational and communication abilities. Competitive compensation...


  • Honolulu, United States Remote Staffing Full time

    Claims Representative | Auto | RemoteBy 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....