Claims Examiner – Auto
| Company | Sedgwick Claims Management Services |
|---|---|
| Location | Madison, WI, USA |
| Salary | $Not Provided – $Not Provided |
| Type | Full-Time |
| Degrees | Bachelor’s |
| Experience Level | Senior |
Requirements
- Bachelor’s degree from an accredited college or university preferred
- Professional certification as applicable to line of business preferred
- 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
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
Preferred Qualifications
- Bachelor’s degree from an accredited college or university preferred
- Professional certification as applicable to line of business preferred