Sedgwick · 9 hours ago

Claims Examiner, Bodily Injury

Tennessee, United States

Full-time

Remote

Mid, Senior Level

$65K/yr - $77K/yr

5+ years exp

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Responsibilities

Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly.

Responsible for litigation process on litigated claims.

Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims.

Reports large claims to excess carrier(s).

Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.

Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage.

Communicates claim action/processing with insured, client, and agent or broker when appropriate.

Performs other duties as assigned.

Supports the organization's quality program(s).

Travels as required.

Qualification

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Claims management experiencePersonalCommercial line auto policiesMedical terminology knowledgeMicrosoft Office proficiencyService expectationsState adjusting licensesSubrogation knowledgeTeamwork ability

Required

Bachelor's degree from an accredited college or university

Secure and maintain the State adjusting licenses as required for the position

Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage’s, principles, and laws

In-depth knowledge of personal and commercial line auto policies, coverage’s, principles, and laws

Knowledge of medical terminology for claim evaluation and Medicare compliance

Knowledge of appropriate application for deductibles, sub-limits, SIR’s, carrier and large deductible programs

Strong oral and written communication, including presentation skills

PC literate, including Microsoft Office products

Strong organizational skills

Strong interpersonal skills

Good negotiation skills

Ability to work in a team environment

Ability to meet or exceed Service Expectations