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Sedgwick · 5 days ago

Account Consultant- Property Adjuster

Washington, DC

Full-time

Hybrid

Senior Level

$65K/yr - $90K/yr

6+ years exp

Sedgwick is a company dedicated to helping people facing unexpected challenges. The Account Consultant- Property Adjuster role involves managing a caseload of complex claims, mentoring team members, and ensuring compliance with jurisdictional requirements.

BankingInsuranceRisk Management

Responsibilities

Utilizes special account instructions to obtain individual customer information and adhere to instructions; identifies, initiates, and coordinates various specialized services such as subrogation, fraud evaluation or case management review to resolve claims

Establishes and maintains effective relationship with internal and external customers and coworkers; communicates effectively and timely

Mentors/coaches account representatives and account specialists; facilitates round table discussions within the assigned team

Investigates, evaluates and resolves claims; identifies potential problems/trends in claim files and takes corrective action or makes corrective recommendations; interprets medical reports and state law or jurisdictional law in claim handling

Applies jurisdictional and medical knowledge to properly assess the indemnity, medical and expense exposure of assigned claims and appropriately interprets and applies insurance coverage

Reviews client files and collaborates with team to prepare information which includes thorough analysis of file strategies, claims status and emerging trends

Proactively manages litigation in conjunction with client requirements; works constructively with client and legal representatives to resolve claims

Ensures compliance and best possible outcomes by minimizing financial liability

Compiles requirements in order to prevent penalties and fines; utilizes instructions and tools provided to ensure that all state required documentation is issued accurately and in timely manner in accordance with specific jurisdictional timeframes and guidelines

Monitors reports as assigned and documents compliance with key jurisdictional requirements (i.e. EDI, timeliness of benefit payments, etc.); assists Team Lead in tracking completion of team’s tasks and projects; reviews SAS/SOX documents and submits in timely manner; and assists with takeover and reverse takeover projects ensuring that claim files are transferred and handled appropriately

Performs other duties as assigned

Supports the organization's quality program(s)

Qualification

State adjuster licensesLegalJurisdictional knowledgeMicrosoft OfficeAnalytical skillsCommunication skillsCustomer service skillsOrganizational skillsInterpersonal skillsTeamwork