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Sedgwick · 8 hours ago

Claims Representative - Liability

Cincinnati, OH

Full-time

Hybrid

Entry Level

2+ years exp

Sedgwick is a global industry leader committed to providing exceptional service and support to clients. The Claims Representative - Liability role involves processing low level general liability claims, determining benefits due, and ensuring claims are adjudicated within company standards.

BankingInsuranceRisk Management

Responsibilities

Processes low 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

Develops and coordinates low level general liability claims' action plans to resolution, return-to-work efforts, and approves claim payments

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

Administers 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 low-level 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 experienceBachelor's degreeProfessional certificationsNegotiation skillsCommunication skills

Required

Bachelor's degree from an accredited college or university preferred

Licenses as required

Professional certifications as applicable to line of business preferred

Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required