claims Adjuster
4 weeks ago
**The 'Apply with SEEK' option will be utilized for International applicants, mainly Australia. If this does not apply to you please use the 'Apply' option.**
claims AdjusterIF YOU CARE, THERES A PLACE FOR YOU HERE
For a career path that is both challenging and rewarding, join Sedgwicks talented team of 27,000 colleagues around the globe. Sedgwick is a leading provider of technology-enabled risk, benefits and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. Whether they have a workplace injury, suffer property or financial loss or damage from a natural or manmade disaster, are involved in an auto or other type of accident, or need time away from work for the birth of a child or another medical situation, we are here to provide compassionate care and expert guidance. Our clients depend on our talented colleagues to take care of their most valuable assetstheir employees, their customers and their property. At Sedgwick, caring counts. Join our team of creative and caring people of all backgrounds, and help us make a difference in the lives of others.
With one of the largest teams of liability experts in the world, Sedgwick supports and resolves property, general, auto, product and professional liability claims. We help our clients maintain brand protection in times of crisis.
**PRIMARY PURPOSE**: 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 FUNCTIONS and RESPONSIBILITIES**
* 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.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
* Performs other duties as assigned.
* Supports the organization's quality program(s).
* Travels as required.
**QUALIFICATION**
**Education & Licensing**
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.
**Skills & Knowledge**
* Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
* Excellent oral and written communication, including presentation skills
* PC literate, including Microsoft Office products
* Analytical and interpretive skills
* Strong organizational skills
* Good interpersonal skills
* Excellent 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
**NOTE**: Credit security clearance, confirmed via a background credit check, is required for this position.
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.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
location5 Locations
-
Workers Compensation Claims Adjuster
1 month ago
Portland, Oregon, United States Insurance Placement Solutions Full timeInsurance Placement Solutions has an immediate opening for a Remote Workers Compensation Claims Adjuster with our client. As a member of our client's claims team, utilize your knowledge of workers' compensation to independently investigate, evaluate and resolve assigned claims in order to achieve appropriate outcomes. In this position, you will administer...
-
Workers Compensation Claims Adjuster
1 week ago
Portland, Oregon, United States Insurance Placement Solutions Full timeInsurance Placement Solutions has an immediate opening for a Remote Workers Compensation Claims Adjuster with our client. As a member of our client's claims team, utilize your knowledge of workers' compensation to independently investigate, evaluate and resolve assigned claims in order to achieve appropriate outcomes. In this position, you will administer...
-
Property Claims Senior Outside Adjuster
2 weeks ago
Portland, United States MMG Insurance Full time** Property Claims Senior Outside Adjuster** **Job Category****:** Property Claims **Requisition Number****:** PROPE001188 Showing 1 location **Job Details** **Description** **MMG INSURANCE COMPANY** **Job Description** **Job Title:** Property Outside Adjuster - Senior **Department:** Property Claims **Reports To:** Manager **FLSA Status:** Exempt...
-
Field Claims Property Adjuster
2 weeks ago
Portland, United States Farmers Insurance Group Full timeCustomer service-focused individuals to build a rewarding long-term career with us as Field Property Claims Adjusters! Applicants who wish to be considered for this role must reside in the WEST Portland, OR area. The starting pay for this position is Property Adjuster, Claims, Field, Adjuster, Property, Customer Service
-
Property Claims General Adjuster
2 months ago
Portland, United States MMG Insurance Full time** Property Claims General Adjuster - Portland, ME** **Job Category****:** Property Claims **Requisition Number****:** PROPE001221 Showing 1 location **Job Details** **Description** **MMG INSURANCE COMPANY** **Job Description** **Job Title:** Property General Adjuster **Department:** Property Claims **Reports To:** Manager **FLSA Status:** Exempt...
-
Property Claims General Adjuster
1 week ago
Portland, United States MMG Insurance Full time** Property Claims General Adjuster - Portland, ME** **Job Category****:** Property Claims **Requisition Number****:** PROPE001221 Showing 1 location **Job Details** **Description** **MMG INSURANCE COMPANY** **Job Description** **Job Title:** Property General Adjuster **Department:** Property Claims **Reports To:** Manager **FLSA Status:** Exempt...
-
General Adjuster
3 weeks ago
Portland, United States McLarens Global Full timeMcLarens is a leading global claims services provider that helps clients achieve timely and equitable claims resolution. McLarens family of brands is trusted by clients worldwide to deliver the best in claims management, loss adjusting and auditing services to pre-risk and damage surveying. With direct operations in over 40 countries and over 2000 team...
-
Senior Workers Compensation Claims Adjuster
4 weeks ago
Portland, United States PMA Insurance Group Full timeAs a member of our claims team, utilize your knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues,...
-
Senior Workers Compensation Claims Adjuster
1 month ago
Portland, United States PMA Companies Full timeAs a member of our claims team, utilize your knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues,...
-
Senior Workers Compensation Claims Adjuster
4 weeks ago
Portland, United States PMA Companies Full timeAs a member of our claims team, utilize your knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues,...
-
Property Adjuster Specialist
5 days ago
Portland, United States United Services Automobile Association - USAA Full timeWe are seeking a dedicated Property Adjuster Specialist Currently located in Portland, OR or Vancouver, WA to join our field Team. As a Insurance Property Adjuster Specialist, you will work within established guidelines and framework to investigate, Property Adjuster, Specialist, Adjuster, Property, Claims, Business Partner
-
1099 Field Property Adjuster
2 months ago
Portland, United States RYZE Claim Solutions Full timeOverview: Field Adjuster I will investigate and evaluate daily property claims for clients pursuant to client and company direction. Provide timely, accurate, fair, and professional service to all clients and insured parties while maintaining a high level of production.Essential Functions:Handles all assigned claims promptly and effectively, with minimal...
-
Claims Assistant
4 weeks ago
Portland, United States CorVel Full timeThe Claims Assistant will assist and support the claims staff in the set-up and administration of workers’ compensation claims/case management and other tasks depending on the specific needs of the customers. In-office role in Portland, OR. ESSENTIAL JOB DUTIES & RESPONSIBILITIES:Sets up new claims Process mail, handle files (until paperless), and input...
-
Claims Assistant
4 weeks ago
Portland, United States CorVel Corporation Full timeThe Claims Assistant will assist and support the claims staff in the set-up and administration of workers’ compensation claims/case management and other tasks depending on the specific needs of the customers. In-office role in Portland, OR. ESSENTIAL JOB DUTIES & RESPONSIBILITIES: Sets up new claims Process mail, handle files (until paperless),...
-
Claims Assistant
5 days ago
Portland, United States CorVel Corporation Full timeThe Claims Assistant will assist and support the claims staff in the set-up and administration of workers’ compensation claims/case management and other tasks depending on the specific needs of the customers. In-office role in Portland, OR. ESSENTIAL JOB DUTIES & RESPONSIBILITIES: Sets up new claims Process mail, handle files (until paperless),...
-
Associate Claim Specialist
3 weeks ago
Portland, United States MEMIC Full timeThe Mission of The MEMIC Group is to make workers' comp work better with compassion, trusted partnerships, and relentless commitment to workforce safety. The secret to the success and longevity of great organizations is their shared vision and strong values. At MEMIC our values are to be conscientious, to be an expert, to be a partner, to be curious and to...
-
Associate Claim Specialist
3 weeks ago
Portland, United States Opportunities at MEMIC Full timeThe Mission of The MEMIC Group is to make workers' comp work better with compassion, trusted partnerships, and relentless commitment to workforce safety. The secret to the success and longevity of great organizations is their shared vision and strong values. At MEMIC our values are to be conscientious, to be an expert, to be a partner, to be curious and to...
-
Associate Claim Specialist
1 week ago
Portland, United States Opportunities at MEMIC Full timeThe Mission of The MEMIC Group is to make workers' comp work better with compassion, trusted partnerships, and relentless commitment to workforce safety. The secret to the success and longevity of great organizations is their shared vision and strong values. At MEMIC our values are to be conscientious, to be an expert, to be a partner, to be curious and to...
-
Medical Only Claims Specialist
4 weeks ago
Portland, United States CorVel Enterprise Comp, Inc. Full timeJob Description Job Description The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of claims department and of CorVel. This is a hybrid role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy...
-
Claims Specialist
2 weeks ago
Portland, United States Fora Health Full timeJob DescriptionJob DescriptionThe mission of Fora Health is to provide treatment, care and advocacy for all who are affected by substance use disorder. We are committed to providing a wide range of accessible, coordinated and well‑integrated services that benefit the community and support our patients to recover and to maintain recovery from addiction. ...