Insurance Claims Specialist

2 weeks ago

Springfield, Illinois, United States Sedgwick Full time

Join Our Team at Sedgwick

At Sedgwick, we prioritize the well-being of our employees, fostering a culture of support and inclusivity. We believe in providing flexibility and time for what matters most to you. A career with us means engaging in meaningful work every day while receiving the necessary support for your mental, physical, financial, and professional growth.

About the Role

As an Insurance Claims Specialist, your primary responsibility will be to assess and manage intricate auto and commercial transportation claims. This involves reviewing coverage, conducting thorough investigations, determining liability, and evaluating damages.

Key Responsibilities

  • Manage complex auto and commercial claims, ensuring accurate documentation and coding.
  • Oversee the litigation process for claims that are in dispute.
  • Coordinate with vendors, including independent adjusters, to facilitate claim investigations.
  • Report significant claims to excess carriers as necessary.
  • Develop action plans to meet state-mandated contact deadlines and ensure timely resolutions.
  • Identify subrogation and risk transfer opportunities; manage salvage processes.
  • Communicate effectively with insured parties, clients, and agents regarding claim status and actions.

Additional Responsibilities

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

Qualifications

Education & Licensing

A bachelor's degree from an accredited institution is preferred. Relevant professional certifications and state adjusting licenses are also preferred.

Experience

A minimum of five years in claims management or a comparable combination of education and experience is required, with a strong understanding of personal and commercial auto policies, coverage, principles, and regulations.

Skills & Knowledge

  • Comprehensive knowledge of personal and commercial auto policies and relevant laws.
  • Familiarity with medical terminology for claims assessment and Medicare compliance.
  • Understanding of deductibles, sub-limits, SIRs, and large deductible programs.
  • Excellent oral and written communication skills, including presentation abilities.
  • Proficient in Microsoft Office and other relevant software.
  • Strong organizational and interpersonal skills.
  • Effective negotiation capabilities.
  • Able to work collaboratively in a team setting.
  • Committed to meeting or exceeding service expectations.

Work Environment

We are committed to providing reasonable accommodations when applicable. The role requires clear thinking, sound judgment, and the ability to manage stress and multiple priorities 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. We value diversity and encourage all qualified candidates to apply, even if their experience does not align perfectly with every qualification.

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