Sedgwick · 1 month ago
Claims Examiner - Auto, General Liability & Bodily Injury | NY, FL, and/or TX license Required (Remote)
United States
Full-time
Remote
Senior Level
5+ years expSedgwick is a global industry leader in claims management, inviting individuals to grow their careers within a caring culture. The Claims Examiner will adjudicate complex customer claims, negotiate settlements, and manage the litigation process to ensure timely and effective claims resolution.
BankingInsuranceRisk Management
Responsibilities
Analyzes and processes complex or technically difficult general liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution
Assesses liability and resolves claims within evaluation
Negotiates settlement of claims within designated authority
Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim
Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level
Prepares necessary state fillings within statutory limits
Manages the litigation process; ensures timely and cost effective claims resolution
Coordinates vendor referrals for additional investigation and/or litigation management
Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients
Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets
Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner
Communicates claim activity and processing with the claimant and the client; maintains professional client relationships
Ensures claim files are properly documented and claims coding is correct
Refers cases as appropriate to supervisor and management
Performs other duties as assigned
Supports the organization's quality program(s)
Travels as required
Qualification
Required
Five (5) years of claims management experience or equivalent combination of education and experience required
Preferred
Bachelor's degree from an accredited college or university preferred
Professional certification as applicable to line of business preferred
NY, FL, and/or TX adjuster license preferred
Benefits
Flexible work schedule.
Referral incentive program.
Opportunity to work in an agile environment.
Career development and promotional growth opportunities.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
Company
Sedgwick
Sedgwick is the world’s leading risk and claims administration partner, helping clients thrive by navigating the unexpected.
10001+ employees
Funding
Current Stage
Late StageTotal Funding
$1.5BKey Investors
Altas PartnersLa Caisse
2024-09-12Private Equity· $1B
2018-12-01Private Equity
2018-09-12Acquired
Leadership Team
Michael Arbour
Chairman & Chief Executive Officer
Kalani Reelitz
Global Chief Financial Officer
Recent News
Morningstar.com
2025-11-10
2025-09-04
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