Senior Claims Adjuster

1 week ago

Michigan, United States Sedgwick Full time

At Sedgwick, we prioritize the well-being of our team members, fostering a culture of support and flexibility. Our commitment to our colleagues means providing an environment where you can thrive both personally and professionally. Here, you will find opportunities to enhance your skills and advance your career while being part of a diverse and inclusive workplace.

As a member of our team, you will engage in meaningful work that positively impacts the lives of individuals and organizations. If you are motivated to make a difference and embrace challenges, we welcome you to explore a fulfilling career with us.

PRIMARY PURPOSE: The role involves evaluating intricate general liability claims to ascertain benefits owed. You will manage high-stakes claims that may involve legal proceedings and rehabilitation efforts, ensuring claims are processed in line with service expectations and industry standards. Additionally, you will identify opportunities for subrogation and negotiate settlements effectively.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:

  • Investigate and assess complex general liability claims, developing comprehensive action plans for timely resolutions.
  • Evaluate liability and settle claims within established guidelines.
  • Negotiate claim settlements within your authority.
  • Assign and manage reserves throughout the claim lifecycle.
  • Process and approve timely claim payments and adjustments.
  • Prepare necessary state filings in compliance with statutory requirements.
  • Oversee the litigation process to ensure efficient claims resolution.
  • Coordinate with vendors for additional investigations or litigation management.
  • Implement cost containment strategies to minimize overall claims expenses.
  • Manage recoveries, including subrogation and offsets.
  • Communicate effectively with claimants and clients, maintaining professional relationships.
  • Ensure accurate documentation and coding of claim files.
  • Refer cases to management as necessary.

ADDITIONAL FUNCTIONS AND RESPONSIBILITIES:

  • Perform other duties as assigned.
  • Support the organization's quality initiatives.
  • Travel as required.

QUALIFICATIONS:

Education & Licensing: A bachelor's degree from an accredited institution is preferred. Relevant professional certification is also desirable.

Experience: A minimum of five years in claims management or a comparable combination of education and experience is required.

Skills & Knowledge:

  • Expertise in insurance principles and laws relevant to the claims process.
  • Strong communication skills, both verbal and written.
  • Proficient in Microsoft Office and other relevant software.
  • Analytical and problem-solving abilities.
  • Excellent organizational and interpersonal skills.
  • Proficient negotiation skills.
  • Able to work collaboratively in a team setting.
  • Commitment to meeting service expectations.

WORK ENVIRONMENT: We strive to provide reasonable accommodations when necessary.

Mental: The role requires clear thinking, sound judgment, and the ability to manage stress and multiple priorities effectively.

Physical: Proficiency in computer use and travel as needed.

Auditory/Visual: Capable of hearing, seeing, and communicating effectively.

NOTE: A background credit check is required for this position.

At Sedgwick, we are an Equal Opportunity Employer and maintain a Drug-Free Workplace.

If you are interested in this position, we encourage you to apply, even if your experience does not align perfectly with every qualification. We value diverse backgrounds and recognize that unique skills and experiences contribute to our workplace.

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