Claims Assessment Specialist
2 weeks ago
Overview: At Sedgwick, we prioritize the well-being of our employees, fostering a culture of support and inclusivity. A career with us means embracing flexibility and engaging in meaningful work that impacts lives positively.
Role Summary: As a Claims Assessment Specialist, your primary responsibility will be to evaluate and manage intricate auto and commercial transportation claims. This involves reviewing coverage details, conducting thorough investigations, determining liability, and assessing the extent of damages.
Key Responsibilities:
- Handle complex auto and commercial claims, ensuring accurate documentation and coding.
- Oversee the litigation process for claims that are in dispute.
- Manage vendor relationships, including independent adjusters, to facilitate claim investigations.
- Report significant claims to excess carriers as necessary.
- Create and maintain action plans to meet state-mandated contact deadlines and ensure timely resolutions.
- Identify subrogation opportunities and manage salvage processes.
- Communicate effectively with insured parties, clients, and agents regarding claim progress.
Additional Duties:
- Perform other assigned tasks as needed.
- Support the organization's quality initiatives.
- Travel as required for the role.
Qualifications:
Education: A bachelor’s degree from an accredited institution is preferred. Relevant professional certifications are also advantageous. Candidates must secure and maintain the necessary state adjusting licenses.
Experience: A minimum of five years in claims management or a comparable mix of education and experience is required, demonstrating a comprehensive understanding of personal and commercial auto policies, coverages, principles, and regulations.
Skills and Knowledge:
- Extensive knowledge of personal and commercial auto policies and related laws.
- Familiarity with medical terminology relevant to claims evaluation and Medicare compliance.
- Understanding of deductibles, sub-limits, 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 thrive in a collaborative team environment.
- Commitment to meeting or exceeding service expectations.
Work Environment: We consider reasonable accommodations when applicable. The role may involve mental challenges such as clear thinking, judgment, problem-solving, and managing multiple priorities. Physical requirements include keyboarding and occasional travel.
Note: A background credit check is necessary for this position.
Pay Transparency: Sedgwick adheres to legal requirements for pay transparency in job postings. Compensation is influenced by various factors, including skill set and experience level.
As an Equal Opportunity Employer and a Drug-Free Workplace, Sedgwick values diversity and encourages all qualified candidates to apply.
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