Insurance Claims Specialist

1 week ago

Fall River, Massachusetts, United States Sedgwick Full time

At Sedgwick, we prioritize the well-being of our employees, recognizing that taking care of our team is essential to our mission. A career with us means embracing a culture of support and flexibility, allowing you to balance your professional and personal life effectively. Here, you have the chance to engage in meaningful work every day, with resources dedicated to your mental, physical, financial, and professional growth. We are committed to fostering an environment that values diversity and inclusivity.

Joining Sedgwick means aligning your passion with purpose, making a positive difference in the lives of individuals and organizations we serve. If you are motivated to contribute, enjoy tackling challenges, and possess a caring nature, we welcome you to be part of our team and help us maintain our reputation as a great workplace.

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

**Position Title:** Claims Specialist - Auto

**PRIMARY PURPOSE:** To evaluate and manage low to mid-level auto and transportation claims.

**ESSENTIAL FUNCTIONS and RESPONSIBILITIES:**

  • Evaluates auto property damage and lower-level injury claims; assesses damages, processes payments, and ensures accurate documentation and coding of claim files according to policy guidelines.
  • Develops and implements action plans to meet state-required deadlines and facilitate prompt resolution of claims.
  • Identifies and pursues opportunities for subrogation; manages salvage processes.
  • Communicates claim status and processing updates with insured parties, clients, and agents or brokers as necessary.
  • Maintains professional relationships with clients.
  • Conducts coverage, liability, and damage assessments for all assigned claims.

**ADDITIONAL FUNCTIONS and RESPONSIBILITIES:**

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

**QUALIFICATIONS:**

**Education & Licensing:**
A bachelor's degree from an accredited institution is preferred but not mandatory. Must secure and maintain the necessary state adjusting licenses for the role. A current home state license is advantageous.

**Skills & Knowledge:**

  • Understanding of personal and commercial lines policies and endorsements.
  • Ability to review and evaluate property damage estimates, total loss assessments, and related expenses to negotiate claims effectively.
  • Knowledge of total loss processing, state salvage documentation, and title requirements.
  • Strong oral and written communication skills, including presentation abilities.
  • Proficient in PC applications, including Microsoft Office.
  • Strong analytical and interpretive skills.
  • Excellent organizational capabilities.
  • Good interpersonal skills.
  • Ability to work collaboratively in a team setting.
  • Ability to meet or exceed service expectations.

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

**Mental Requirements:** Clear and conceptual thinking abilities; excellent judgment, problem-solving skills, and discretion; capacity to manage work-related stress; ability to prioritize multiple tasks and meet deadlines.

**Physical Requirements:** Proficient in computer keyboarding; travel as required.

**Auditory/Visual Requirements:** Capable of hearing, vision, and verbal communication.

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

The details provided in this document aim to outline the general nature and level of work performed by a colleague in this role. They are not intended to be an exhaustive list of functions, duties, or local variations. Management retains the right to modify the responsibilities of the position at any time.

**Pay Transparency:**
As mandated by law, Sedgwick offers a reasonable compensation range for roles that may be posted in jurisdictions requiring pay transparency. Actual compensation is influenced by various factors, including skill set, experience level, and specific location costs. For this job posting, the starting pay range is $50,000. A comprehensive benefits package is available, including medical, dental, vision, 401k with matching, PTO, disability and life insurance, employee assistance programs, flexible spending or health savings accounts, and other voluntary benefits.

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

**If you are enthusiastic about this position but your experience does not perfectly match every qualification listed, 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. You may be the ideal candidate for this or other opportunities.**

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