Claims Assessment Specialist

2 weeks ago


Lansing, Michigan, United States Sedgwick Full time

Overview:
At Sedgwick, we prioritize the well-being of our colleagues, fostering a culture of support and inclusivity. Our commitment to care extends to our clients and the communities we serve, ensuring that every day presents an opportunity to make a meaningful impact.

Role Summary:
The Claims Examiner is responsible for the thorough analysis and processing of intricate auto and commercial transportation claims. This involves a detailed review of coverage, conducting investigations, determining liability, and assessing the extent of damages.

Key Responsibilities:
1. Manage complex auto and commercial claims, ensuring all files are accurately documented and coded.
2. Oversee the litigation process for claims that are under legal scrutiny.
3. Coordinate with vendors, including independent adjusters, to facilitate comprehensive investigations.
4. Report significant claims to excess carriers as necessary.
5. Develop action plans to meet state-mandated contact deadlines and ensure timely resolutions.
6. Identify subrogation and risk transfer opportunities, and manage salvage processes.
7. Maintain clear communication regarding claim status with insured parties, clients, and brokers.

Additional Duties:
Perform other assigned tasks and support the organization's quality initiatives. Travel may be required as part of the role.

Qualifications:
Education: A bachelor's degree from an accredited institution is preferred. Relevant professional certifications and state adjusting licenses are also advantageous.
Experience: A minimum of five years in claims management or a comparable combination of education and experience, with a strong understanding of personal and commercial auto policies and regulations.

Skills:
- In-depth knowledge of auto insurance policies and legal principles.
- Familiarity with medical terminology for effective claim evaluation.
- Proficient in the application of deductibles, sub-limits, and large deductible programs.
- Excellent oral and written communication skills, including the ability to present information clearly.
- Proficient in Microsoft Office and other relevant software.
- Strong organizational and interpersonal skills, with effective negotiation abilities.
- Ability to thrive in a collaborative team environment and meet service expectations.

Work Environment:
Consideration will be given to reasonable accommodations as needed. The role requires mental acuity for problem-solving and managing multiple priorities, as well as physical capabilities for computer use and travel.

Note:
All candidates must undergo a background credit check as part of the hiring process. Sedgwick is an Equal Opportunity Employer and maintains a drug-free workplace.

Conclusion:
At Sedgwick, we recognize the unique skills and experiences each individual brings. We are committed to building a diverse and inclusive workplace where everyone can thrive.



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