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Sedgwick · 2 days ago

Claims Adjuster - Liability | GL, BI, Auto and PD | Jurisdiction: All states | NY and HI preferred (Hybrid)

Irving, TX

Full-time

Hybrid

Mid Level

4+ years exp

Sedgwick is a global industry leader dedicated to helping people facing unexpected challenges. The Claims Adjuster will adjudicate complex customer claims, manage general liability claims, and negotiate settlements while ensuring adherence to company standards and best practices.

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