Claim Representative

2 days ago

Naperville, Illinois, United States Sedgwick Full time
About the Role

Sedgwick is seeking a skilled Claim Representative to join our team. As a Claim Representative, you will play a critical role in analyzing reports, determining benefits, and making timely payments and adjustments. You will also coordinate investigative efforts, thoroughly review contested claims, and negotiate settlements up to the designated authority level.

Key Responsibilities
  • Manage first-party property, casualty, and/or medical reimbursement claims based on multiple/additional coverage and/or programs as defined by client-specific programs.
  • Makes coverage determinations based on investigation/evaluation and communicates claim actions with claimant and client.
  • Adjudicates proper settlement up to designated authority level.
  • Works directly with underwriter/client on high-value and complex cases.
  • Handles high volumes of claims, phone calls, and correspondence, ensuring claim files are properly documented, meets quality and production goals, and meets customer guidelines and deadlines.
Requirements
  • Bachelor's degree from an accredited college or university preferred.
  • Professional certification as applicable to line of business preferred.
  • Three (3) years of claims management experience or equivalent combination of experience and education required.
  • In-depth knowledge of first-party property and casualty claim adjudication as applicable to line of business.
  • Excellent oral and written communication, including presentation skills.
  • PC literate, including Microsoft Office products.
  • Excellent analytical and interpretive skills.
  • Excellent organizational skills.
  • Excellent interpersonal skills.
  • Ability to work in a team environment.
  • Ability to meet or exceed Performance Competencies.
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.

At Sedgwick, we believe that caring counts. We take care of people, our colleagues, and our clients. We strive to make a positive impact on the world through the people and organizations we serve.

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