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Sedgwick · 1 month ago

General Liability Adjuster

United States

Full-time

Remote

Mid Level

4+ years exp

Sedgwick is a leading company in the insurance sector, recognized for its commitment to a positive workplace culture. The General Liability Adjuster will analyze and manage mid- and higher-level general liability claims, ensuring compliance with company standards and industry best practices while negotiating settlements and maintaining client relationships.

BankingInsuranceRisk Management

Responsibilities

Manages mid-level general liability claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level

Assesses liability and resolves claims within evaluation

Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract

Manages subrogation of claims and negotiates settlements

Communicates claim action with claimant and client

Ensures claim files are properly documented and claims coding is correct

May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review

Maintains professional client relationships

Performs other duties as assigned

Supports the organization's quality program(s)

Travels as required

Qualification

Claims management experienceInsurance principles knowledgeNegotiation skillsAnalytical skillsCommunication skillsService expectationsPC literacyOrganizational skillsInterpersonal skillsTeamwork ability

Required

NY license required

Four (4) 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, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business

Excellent oral and written communication, including presentation skills

PC literate, including Microsoft Office products

Analytical and interpretive skills

Strong organizational skills

Good interpersonal skills

Excellent negotiation skills

Ability to work in a team environment

Ability to meet or exceed Service Expectations