Claims Examiner - Bodily Injury - Auto
PRIMARY PURPOSE: To analyze and process complex bodily injury auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES- Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly.
- Responsible for litigation process on litigated claims.
- Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims.
- Reports large claims to excess carrier(s).
- Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.
- Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage.
- Communicates claim action/processing with insured, client, and agent or broker when appropriate.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES- Performs other duties as assigned.
- Supports the organization's quality program(s).
- Travels as required.
QUALIFICATIONSEducation & LicensingBachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Secure and maintain the State adjusting licenses as required for the position.
ExperienceFive (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws.
Skills & Knowledge- In-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws
- Knowledge of medical terminology for claim evaluation and Medicare compliance
- Knowledge of appropriate application for deductibles, sub-limits, SIR's, carrier and large deductible programs.
- Strong oral and written communication, including presentation skills
- PC literate, including Microsoft Office products
- Strong organizational skills
- Strong interpersonal skills
- Good negotiation skills
- Ability to work in a team environment
- Ability to meet or exceed Service Expectations
Job type: We are currently hiring for this position
Compensation Information: Salary Range: $67,847.00 - $88,201.00 - $108,555.00CAD annually
This position is full-time, and compensation is salaried.
Compensation is determined based on experience, qualifications, and internal equity. Sedgwick is committed to transparent and equitable pay practices.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Where applicable, Sedgwick uses artificial intelligence tools to assist in the screening, assessment, or selection of candidates. These tools are subject to periodic review.
