Claims Examiner

3 weeks ago


Helena, Montana, United States Sedgwick Full time

Role Overview

Sedgwick is seeking a skilled Claims Examiner to join our team. As a Claims Examiner, you will be responsible for analyzing complex liability claims, determining benefits due, and ensuring ongoing adjudication of claims within service expectations and industry best practices.

Key Responsibilities

  • Analyze and process complex liability claims by investigating and gathering information to determine the exposure on the claim.
  • Manage claims through well-developed action plans to an appropriate and timely resolution.
  • Negotiate settlement of claims within designated authority.
  • Calculate and assign timely and appropriate reserves to claims.
  • Manage claim recoveries, including subrogation, Second Injury Fund excess recoveries, and Social Security and Medicare offsets.

Requirements

  • Bachelor's degree from an accredited college or university preferred.
  • Five (5) years of claims management experience or equivalent combination of education and experience required.
  • Subject matter expert of appropriate insurance principles and laws for line-of-business handled.
  • Excellent oral and written communication, including presentation skills.
  • PC literate, including Microsoft Office products.

What We Offer

Sedgwick offers a comprehensive benefits package, including medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

About Sedgwick

Sedgwick is a leading global provider of technology-enabled risk, benefits, and integrated business solutions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts.



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