Claims Analyst

1 week ago

Remote, Oregon, United States Sedgwick Full time

At Sedgwick, we prioritize the well-being of our employees, fostering a culture of support and inclusivity. Joining our team means you will experience a work environment that values flexibility and recognizes the importance of work-life balance. Here, you have the chance to engage in meaningful work that positively impacts the lives of others.

A career with us is where your passion aligns with purpose, allowing you to contribute to the betterment of the communities we serve. If you are motivated to make a difference and thrive in a challenging environment, we welcome you to explore opportunities with us.

Recognitions:
Great Place to Work
Most Loved Workplace
Forbes Best-in-State Employer

Position Overview:
PRIMARY PURPOSE: To evaluate and manage intricate auto and commercial transportation claims by assessing coverage, conducting investigations, determining liability, and analyzing the extent of damages.

KEY FUNCTIONS AND RESPONSIBILITIES:

  • Handles complex auto, commercial, and personal line claims, including bodily injury, ensuring accurate documentation and coding of claim files.
  • Oversees the litigation process for claims that are in dispute.
  • Coordinates with vendors, including independent adjusters, to facilitate the investigation of claims.
  • Reports significant claims to excess carriers.
  • Develops and maintains action plans to meet state-mandated contact deadlines and to expedite the resolution of claims.
  • Identifies and pursues opportunities for subrogation and risk transfer; manages salvage processes.
  • Communicates claim progress and processing updates with insured parties, clients, and agents or brokers as necessary.

ADDITIONAL FUNCTIONS AND RESPONSIBILITIES:

  • Performs other duties as assigned.
  • Supports the organization's quality assurance programs.
  • Travels as required.

QUALIFICATIONS:

Education & Licensing:
A bachelor's degree from an accredited institution is preferred. Professional certification relevant to the line of business is also preferred. Must secure and maintain state adjusting licenses as required for the role.

Experience:
Previous experience in bodily injury claims (both represented and non-represented) is preferred. Litigation experience is advantageous but not mandatory.

Skills & Knowledge:

  • Comprehensive understanding of personal and commercial auto policies, coverages, principles, and regulations.
  • Familiarity with medical terminology for effective claim evaluation and Medicare compliance.
  • Knowledge of applicable deductibles, sub-limits, self-insured retentions, and large deductible programs.
  • Excellent oral and written communication skills, including presentation abilities.
  • Proficient in PC applications, including Microsoft Office Suite.
  • Strong organizational and interpersonal skills.
  • Effective negotiation capabilities.
  • Able to collaborate within a team environment.
  • Capable of meeting or exceeding service expectations.

WORK ENVIRONMENT:
Reasonable accommodations will be considered when applicable and appropriate.

Mental: Requires clear and conceptual thinking abilities, sound judgment, problem-solving skills, and the capacity to manage work-related stress while handling multiple priorities and meeting deadlines.

Physical: Involves computer keyboarding and travel as necessary.

Auditory/Visual: Requires hearing, vision, and verbal communication.

NOTE: A credit security clearance, confirmed through a background credit check, is required for this position.

Pay Transparency:
As mandated by law, Sedgwick provides a reasonable compensation range for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by various factors, including skill set, experience level, and specific location costs. A comprehensive benefits package is offered, including medical, dental, vision, 401k matching, PTO, disability and life insurance, employee assistance programs, flexible spending or health savings accounts, and additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and maintains a Drug-Free Workplace.

If you are enthusiastic about this role but feel your experience does not perfectly match every qualification, we encourage you to apply anyway. Sedgwick is committed to building a diverse, equitable, and inclusive workplace and recognizes that each individual brings a unique combination of skills, knowledge, and experience.

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