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Business, Entrepreneurialism, and Management

Claims Adjusters, Examiners, and Investigators

Review settled claims to determine that payments and settlements are made in accordance with company practices and procedures.

A Day In The Life

Business, Entrepreneurialism, and Management Field of Interest

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Salary Breakdown

Claims Adjusters, Examiners, and Investigators

Average

$59,030

ANNUAL

$28.38

HOURLY

Entry Level

$37,760

ANNUAL

$18.16

HOURLY

Mid Level

$55,350

ANNUAL

$26.61

HOURLY

Expert Level

$80,370

ANNUAL

$38.64

HOURLY


Program Recommendations

Claims Adjusters, Examiners, and Investigators

Phoenix College (MCCCD)

Associate in Arts, Emphasis in Law and Policy

Education

Associate's Degree


Current Available & Projected Jobs

Claims Adjusters, Examiners, and Investigators

90

Current Available Jobs

15,160

Projected job openings through 2030


Top Expected Tasks

Claims Adjusters, Examiners, and Investigators


Knowledge, Skills & Abilities

Claims Adjusters, Examiners, and Investigators

Common knowledge, skills & abilities needed to get a foot in the door.

KNOWLEDGE

Customer and Personal Service

KNOWLEDGE

English Language

KNOWLEDGE

Administrative

KNOWLEDGE

Mathematics

KNOWLEDGE

Computers and Electronics

SKILL

Reading Comprehension

SKILL

Active Listening

SKILL

Critical Thinking

SKILL

Speaking

SKILL

Judgment and Decision Making

ABILITY

Written Comprehension

ABILITY

Oral Comprehension

ABILITY

Oral Expression

ABILITY

Deductive Reasoning

ABILITY

Inductive Reasoning


Job Opportunities

Claims Adjusters, Examiners, and Investigators

  • Senior Bodily Injury Claims Adjuster
    American Family Insurance - Corporate    Phoenix, AZ 85067
     Posted about 8 hours    

    At American Family Insurance Claims Services (AFICS, Inc.), we're embarking on a transformation of our claims capabilities that will put customers at the center of what we do best – protecting and restoring their dreams when they need us most. We're leveraging our expertise, technology and new ways of working to actively reinvent one of America's largest industries—creating positive impact that empowers our customers, communities, and company to thrive. We are problem solvers who ask critical questions and consistently tackle challenges big and small. Together, we disrupt what's expected of insurance.

    This is a senior level role that Investigates and maintains complex or highly complex claims bodily injury claims. You will determine liability, secures information, reviews coverages, arranges appraisals, and settles claims. Will specialize in liability and bodily injury claims. You will report to the Bodily Injury Claims Manager.

    Position Compensation Range:

    $67,000.00 - $111,000.00

    Pay Rate Type:

    Salary

    _Compensation may vary based on the job level and your geographic work location._

    Primary Accountabilities

    + Investigate origin and cause of claims by contacting the appropriate parties including insureds, claimants, agents, attorneys, contractors, experts, special investigation unit, other adjusters, public personnel, etc.

    + Identify complex issues and seeks assistance as needed. Handles claims on a good faith basis.

    + Handle both 1st party and 3rd party claims under multiple policy types and numerous endorsements.

    + Conduct on-site inspections when needed, evaluates damages and handles claim negotiations with insureds, claimants, attorneys, public adjusters.

    + Respond to customer inquiries, makes appropriate decisions, and closes file.

    + Interpret and determine policies, leases, by-laws, declarations, articles, and contract coverages and applies to all parties for assigned losses.

    + Make independent decisions and self-supervise most files and recognize when assistance is needed.

    + Provide all parties with claim process and status; answers questions or redirects to other areas.

    + Serve as a mentor and subject matter expert for less experienced adjusters.

    Specialized Knowledge & Skills Requirements

    + Demonstrated experience providing customer-driven solutions, support or service.

    + Demonstrated experience handling 1st and 3rd party, multi-line claims.

    + Demonstrated experience handling simple to moderately complex.

    + Extensive knowledge and understanding of policies and endorsements.

    + Extensive knowledge of each phase of the claim handling process.

    Other Preferred Qualifications

    + Bodily injury claims experience

    + Investigation and liability determination experience

    Licenses

    + Obtain state specific property casualty claims licensing as required.

    Travel Requirements

    + Up to 10%.

    + Catastrophe travel up to 75% as applicable.

    Physical Requirements

    + Work that primarily involves sitting/standing.

    Location

    In this primarily home-based role, you will spend 80% of your time (4+ days per week) working from home. External candidates must reside within a 50-mile radius (or 35-mile radius for Boston / Chicago) of one of the following locations: Madison, WI 53783; Boston, MA 02110; Chicago, IL 60601; Denver, CO 80112; Eden Prairie, MN 55343; Keene, NH 03431; St. Joseph, MO 64507; Phoenix, AZ 85034; Nashville, TN 37214.

    On occasion you may be asked to travel to an office location for in person engagement activities such as team meetings, trainings, and culture events.

    Internal candidates are encouraged to apply regardless of location and will be considered based upon the needs of the role.

    \#LI-Remote

    **Other**

    + Offer to selected candidate will be made contingent on the results of applicable background checks

    + Offer to selected candidate is contingent on signing a non-disclosure agreement for proprietary information, trade secrets, and inventions

    + Our policy restricts consideration of applicants needing employment sponsorship (visa) to specialty occupations. Sponsorship will not be considered for this position

    + The candidate(s) selected for this role will be employed by AFICS, Inc. (American Family Insurance Claims Services, Inc.), an affiliate of American Family Mutual Insurance Company, S.I.

    We encourage you to apply even if you do not meet all of the requirements listed above. Skills can be used in many different ways, and your life and professional experience may be relevant beyond what a list of requirements will capture. We encourage those who are passionate about what we do to apply!

    We provide benefits that support your physical, emotional, and financial wellbeing. You will have access to comprehensive medical, dental, vision and wellbeing benefits that enable you to take care of your health. We also offer a competitive 401(k) contribution, a pension plan, an annual incentive, 9 paid holidays and a paid time off program (23 days accrued annually for full-time employees). In addition, our student loan repayment program and paid-family leave are available to support our employees and their families. Interns and contingent workers are not eligible for American Family Insurance Group benefits.

    We are an equal opportunity employer. It is our policy to comply with all applicable federal, state and local laws pertaining to non-discrimination, non-harassment and equal opportunity. We also consider qualified applicants with criminal histories, consistent with applicable federal, state and local law.

    At American Family Insurance, we know how hard our customers and employees work to achieve their dreams. That’s why, for over 90 years, we’ve made it our mission to protect those dreams. It’s all part of who we are and who we’ll always be – innovative, caring, agile, trustworthy, transparent and passionate. We’re a strong, forward-looking company and a proven leader in our industry. And if you’re looking to make a difference, we’re looking for you.

    Join Our Enterprise Talent Community (https://urldefense.com/v3/\_\_https:/pages.beamery.com/afienterprise/page/talcom\_\_;!!EaFwQfVEJhAZolrQq2b3eQ!EQmufXtW66m4H\_M42DdzooeUV\_KXsdG4oYItzWH0aKsEehRY9XJVVfq\_UQO-9e98KBsvG7-G$) !


    Employment Type

    Full Time

  • Claims Examiner - Workers Compensation | Midwest Jurisdictions
    Sedgwick    Tucson, AZ 85702
     Posted 1 day    

    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

    A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

    Great Place to Work®

    Most Loved Workplace®

    Forbes Best-in-State Employer

    Claims Examiner - Workers Compensation | Midwest Jurisdictions

    Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?

    + Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.

    + Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.

    + Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

    + Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.

    + Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.

    + Enjoy flexibility and autonomy in your daily work, your location, and your career path.

    + Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

    **ARE YOU AN IDEAL CANDIDATE?** We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

    **PREFERRED GEOGRAPHIC LOCATIONS**

    Midwest & West Regions

    Candidates outside of the preferred geographic regions listed above may still be considered based on level of experience.

    **PRIMARY PURPOSE OF THE ROLE:** To analyze high-level Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

    **ESSENTIAL RESPONSIBLITIES MAY INCLUDE**

    + Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.

    + Negotiating settlement of claims within designated authority.

    + Communicating claim activity and processing with the claimant and the client.

    + Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

    **QUALIFICATIONS**

    Education & Licensing: 5+ years of claims management experience or equivalent combination of education and experience required.

    + High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.

    + Professional certification as applicable to line of business preferred.

    **Licensing / Jurisdiction Knowledge: Must have active adjusters license & experience handling Midwest jurisdictions.**

    **TAKING CARE OF YOU**

    + Flexible work schedule.

    + Referral incentive program.

    + Career development and promotional growth opportunities.

    + A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

    \#claimsexaminer #claims

    Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

    **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**

    **Taking care of people is at the heart of everything we do. Caring counts**

    Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)


    Employment Type

    Full Time

  • Claims Examiner - Workers Compensation | Midwest Jurisdictions
    Sedgwick    Phoenix, AZ 85067
     Posted 1 day    

    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

    A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

    Great Place to Work®

    Most Loved Workplace®

    Forbes Best-in-State Employer

    Claims Examiner - Workers Compensation | Midwest Jurisdictions

    Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?

    + Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.

    + Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.

    + Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

    + Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.

    + Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.

    + Enjoy flexibility and autonomy in your daily work, your location, and your career path.

    + Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

    **ARE YOU AN IDEAL CANDIDATE?** We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

    **PREFERRED GEOGRAPHIC LOCATIONS**

    Midwest & West Regions

    Candidates outside of the preferred geographic regions listed above may still be considered based on level of experience.

    **PRIMARY PURPOSE OF THE ROLE:** To analyze high-level Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

    **ESSENTIAL RESPONSIBLITIES MAY INCLUDE**

    + Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.

    + Negotiating settlement of claims within designated authority.

    + Communicating claim activity and processing with the claimant and the client.

    + Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

    **QUALIFICATIONS**

    Education & Licensing: 5+ years of claims management experience or equivalent combination of education and experience required.

    + High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.

    + Professional certification as applicable to line of business preferred.

    **Licensing / Jurisdiction Knowledge: Must have active adjusters license & experience handling Midwest jurisdictions.**

    **TAKING CARE OF YOU**

    + Flexible work schedule.

    + Referral incentive program.

    + Career development and promotional growth opportunities.

    + A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

    \#claimsexaminer #claims

    Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

    **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**

    **Taking care of people is at the heart of everything we do. Caring counts**

    Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)


    Employment Type

    Full Time

  • Claims Examiner - Auto/Bodily Injury REMOTE
    Sedgwick    Phoenix, AZ 85067
     Posted 1 day    

    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

    A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

    Great Place to Work®

    Most Loved Workplace®

    Forbes Best-in-State Employer

    Claims Examiner - Auto/Bodily Injury REMOTE

    .

    **CLAIMS EXAMINER- BODILY INJURY**

    Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?

    + Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.

    + Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.

    + Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

    + Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.

    + Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.

    + Enjoy flexibility and autonomy in your daily work, your location, and your career path.

    + Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

    **PRIMARY PURPOSE OF THE ROLE:** We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

    **ARE YOU AN IDEAL CANDIDATE?** To analyze bodily injury claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

    **ESSENTIAL RESPONSIBLITIES MAY INCLUDE:**

    + Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.

    + Negotiating settlement of claims within designated authority.

    + Communicating claim activity and processing with the claimant and the client.

    + Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

    **QUALIFICATIONS**

    Education & Licensing: At least 3 years of claims management experience or equivalent combination of education and experience required.

    + High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.

    + Professional certification as applicable to line of business preferred.

    + Licensing / Jurisdiction Knowledge: Need prior auto experience, rental auto is a plus

    **TAKING CARE OF YOU**

    + Flexible work schedule.

    + Referral incentive program.

    + Opportunity to work in an agile environment.

    + Career development and promotional growth opportunities.

    + A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

    **Work environment requirements for entry-level opportunities include –**

    + Physical: Computer keyboarding

    + Auditory/visual: Hearing, vision and talking

    + Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines

    As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $54,225.00. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

    Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

    **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**

    **Taking care of people is at the heart of everything we do. Caring counts**

    Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)


    Employment Type

    Full Time

  • Claims Examiner - Workers Compensation | Midwest Jurisdictions
    Sedgwick    Flagstaff, AZ 86011
     Posted 1 day    

    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

    A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

    Great Place to Work®

    Most Loved Workplace®

    Forbes Best-in-State Employer

    Claims Examiner - Workers Compensation | Midwest Jurisdictions

    Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?

    + Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.

    + Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.

    + Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

    + Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.

    + Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.

    + Enjoy flexibility and autonomy in your daily work, your location, and your career path.

    + Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

    **ARE YOU AN IDEAL CANDIDATE?** We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

    **PREFERRED GEOGRAPHIC LOCATIONS**

    Midwest & West Regions

    Candidates outside of the preferred geographic regions listed above may still be considered based on level of experience.

    **PRIMARY PURPOSE OF THE ROLE:** To analyze high-level Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

    **ESSENTIAL RESPONSIBLITIES MAY INCLUDE**

    + Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.

    + Negotiating settlement of claims within designated authority.

    + Communicating claim activity and processing with the claimant and the client.

    + Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

    **QUALIFICATIONS**

    Education & Licensing: 5+ years of claims management experience or equivalent combination of education and experience required.

    + High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.

    + Professional certification as applicable to line of business preferred.

    **Licensing / Jurisdiction Knowledge: Must have active adjusters license & experience handling Midwest jurisdictions.**

    **TAKING CARE OF YOU**

    + Flexible work schedule.

    + Referral incentive program.

    + Career development and promotional growth opportunities.

    + A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

    \#claimsexaminer #claims

    Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

    **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**

    **Taking care of people is at the heart of everything we do. Caring counts**

    Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)


    Employment Type

    Full Time

  • Claims Examiner - Auto/Bodily Injury REMOTE
    Sedgwick    Flagstaff, AZ 86011
     Posted 1 day    

    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

    A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

    Great Place to Work®

    Most Loved Workplace®

    Forbes Best-in-State Employer

    Claims Examiner - Auto/Bodily Injury REMOTE

    .

    **CLAIMS EXAMINER- BODILY INJURY**

    Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?

    + Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.

    + Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.

    + Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

    + Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.

    + Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.

    + Enjoy flexibility and autonomy in your daily work, your location, and your career path.

    + Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

    **PRIMARY PURPOSE OF THE ROLE:** We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

    **ARE YOU AN IDEAL CANDIDATE?** To analyze bodily injury claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

    **ESSENTIAL RESPONSIBLITIES MAY INCLUDE:**

    + Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.

    + Negotiating settlement of claims within designated authority.

    + Communicating claim activity and processing with the claimant and the client.

    + Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

    **QUALIFICATIONS**

    Education & Licensing: At least 3 years of claims management experience or equivalent combination of education and experience required.

    + High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.

    + Professional certification as applicable to line of business preferred.

    + Licensing / Jurisdiction Knowledge: Need prior auto experience, rental auto is a plus

    **TAKING CARE OF YOU**

    + Flexible work schedule.

    + Referral incentive program.

    + Opportunity to work in an agile environment.

    + Career development and promotional growth opportunities.

    + A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

    **Work environment requirements for entry-level opportunities include –**

    + Physical: Computer keyboarding

    + Auditory/visual: Hearing, vision and talking

    + Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines

    As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $54,225.00. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

    Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

    **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**

    **Taking care of people is at the heart of everything we do. Caring counts**

    Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)


    Employment Type

    Full Time

  • Claims Examiner - Auto/Bodily Injury REMOTE
    Sedgwick    Tucson, AZ 85702
     Posted 1 day    

    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

    A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

    Great Place to Work®

    Most Loved Workplace®

    Forbes Best-in-State Employer

    Claims Examiner - Auto/Bodily Injury REMOTE

    .

    **CLAIMS EXAMINER- BODILY INJURY**

    Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?

    + Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.

    + Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.

    + Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

    + Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.

    + Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.

    + Enjoy flexibility and autonomy in your daily work, your location, and your career path.

    + Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

    **PRIMARY PURPOSE OF THE ROLE:** We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

    **ARE YOU AN IDEAL CANDIDATE?** To analyze bodily injury claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

    **ESSENTIAL RESPONSIBLITIES MAY INCLUDE:**

    + Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.

    + Negotiating settlement of claims within designated authority.

    + Communicating claim activity and processing with the claimant and the client.

    + Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

    **QUALIFICATIONS**

    Education & Licensing: At least 3 years of claims management experience or equivalent combination of education and experience required.

    + High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.

    + Professional certification as applicable to line of business preferred.

    + Licensing / Jurisdiction Knowledge: Need prior auto experience, rental auto is a plus

    **TAKING CARE OF YOU**

    + Flexible work schedule.

    + Referral incentive program.

    + Opportunity to work in an agile environment.

    + Career development and promotional growth opportunities.

    + A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

    **Work environment requirements for entry-level opportunities include –**

    + Physical: Computer keyboarding

    + Auditory/visual: Hearing, vision and talking

    + Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines

    As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $54,225.00. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

    Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

    **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**

    **Taking care of people is at the heart of everything we do. Caring counts**

    Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)


    Employment Type

    Full Time

  • Field Property Contents Claim Representative
    Travelers Insurance Company    Phoenix, AZ 85067
     Posted 2 days    

    **Who Are We?**

    Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.

    **Job Category**

    Claim

    **Compensation Overview**

    The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.

    **Salary Range**

    $60,600.00 - $100,100.00

    **Target Openings**

    1

    **What Is the Opportunity?**

    This position services Insureds/Agents in and around Denver, CO or Phoenix, AZ. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory.

    Under general supervision, this position is responsible for the handling of the contents portion of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business property claims of moderate to high severity, i.e. Major Case Unit losses. Assists in the investigating, scoping and estimating for any and all lines of business as needed, i.e., auto, general liability, workers compensation and underwriting as required. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations.

    This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence.

    As of the date of this posting, Travelers anticipates that this posting will remain open until Thursday, June 6, 2024.

    **What Will You Do?**

    + Handles 1st party property content claims with moderate to high severity, i.e. Major Case Unit losses.

    + Occasionally handles 1st party property claims of moderate complexity as assigned.

    + Completes field inspection of losses including accurate scope of contents damages, photographs, written estimates and/or computer assisted estimates.

    + Broad scale use of innovative technologies.

    + Investigates and evaluates all relevant facts to determine coverage, damages and liability of first party property damage claims. Secures recorded or written statements as necessary and works with proper business partners to maximize company resources for specialized investigation and evaluation.

    + Works with and effectively manages contents vendors involved with the claim i.e. textile, electronic and contents’ restoration vendors.

    + Negotiates with vendors or insured’s representatives.

    + Establishes timely and accurate claim and expense reserves.

    + Determines appropriate settlement amount based on independent judgment, computer assisted contents estimate, estimation of actual cash value and replacement value, vendor estimate validation, appraisals, application of applicable limits and deductibles.

    + Negotiates and conveys claim settlements within authority limits.

    + Writes denial letters, Reservation of Rights and other complex correspondence.

    + Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools.

    + Meets all quality standards and expectations in accordance with the Knowledge Guides.

    + Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures.

    + Manages file inventory to ensure timely resolution of cases.

    + Handles files in compliance with state regulations, where applicable

    + Provides excellent customer service to meet the needs of the insured, agent, and all other internal and external customers/business partners.

    + Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit.

    + Performs administrative functions such as expense accounts, time off reporting, etc. as required.

    + Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed.

    + Actively provides mentoring and coaching to less experienced claim professionals.

    + May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.

    + Partners with other Property Claim professionals to provide training and to share knowledge and expertise in the adjustment and handling of contents claims.

    + CAT Duty ~ This position will require participation in our Catastrophe Response Program, which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states.

    + Must secure and maintain company credit card required.

    + In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.

    + Other duties as assigned.

    + Perform other duties as assigned.

    **What Will Our Ideal Candidate Have?**

    + Bachelor's Degree preferred.

    + Two or more years of previous outside property claim handling experience preferred.

    + Interpersonal and customer service skills- Advanced

    + Organizational and time management skills - Advanced

    + Ability to work independently – Advanced

    + Judgment, analytical thinking and decision making skills - Intermediate

    + Negotiation skills- Intermediate

    + Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively - Intermediate

    + Investigative skills – Intermediate

    + Ability to analyze and determine coverage – Intermediate

    + Analyze, and evaluate damages – Intermediate

    + Resolve claims within settlement authority - Intermediate

    **What is a Must Have?**

    + High School Diploma or GED required.

    + A minimum of one year previous property claim handling experience or successful completion of Travelers Claim Representative training program required.

    + Valid driver's license required.

    **What Is in It for You?**

    + **Health Insurance** : Employees and their eligible family members – including spouses, domestic partners, and children – are eligible for coverage from the first day of employment.

    + **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.

    + **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.

    + **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.

    + **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.

    **Employment Practices**

    Travelers is an equal opportunity employer. We believe that we can deliver the very best products and services when our workforce reflects the diverse customers and communities we serve. We are committed to recruiting, retaining and developing the diverse talent of all of our employees and fostering an inclusive workplace, where we celebrate differences, promote belonging, and work together to deliver extraordinary results.

    In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.

    If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email ([email protected]) so we may assist you.

    Travelers reserves the right to fill this position at a level above or below the level included in this posting.

    To learn more about our comprehensive benefit programs please visit http://careers.travelers.com/life-at-travelers/benefits/ .


    Employment Type

    Full Time

  • STD Claims Manager
    Lincoln Financial Group    Phoenix, AZ 85067
     Posted 2 days    

    **Alternate Locations:** Work from Home; Atlanta, GA (Georgia); Boston, MA (Massachusetts); Charlotte, NC (North Carolina); Dover, NH (New Hampshire); Omaha, NE (Nebraska); Phoenix, AZ (Arizona)

    **Work Arrangement:**

    Remote : Work at home employee residing outside of a commutable distance to an office location.

    **Relocation assistance:** is not available for this opportunity.

    **Requisition #:** 72952

    **The Role at a Glance**

    We are excited to bring on a highly motivated Claims Manager to support our Group Protection organization in a work from home environment.

    Background details

    As a Claims Manager, you will be responsible for coaching and developing a team including a team of Claims Specialists and a Claims Supervisor, navigating individual and team priorities and supporting organizational initiatives with a strong emphasis on relationship building and change management. If you enjoy building deep relationship with our customers while helping other achieve their best, please read on!

    **What you'll be doing**

    + You will manage and evaluate individual and team performance while taking appropriate actions to meet or exceed performance standards.

    + You will provide training and development opportunities, including stretch assignments, for your team members. This includes giving honest and open feedback to aid in the development of talent. You will also ensure that top talent is hired and retained.

    + You will proactively identify areas of opportunity on both the individual and organizational level, working with other managers to drive improvement through various initiatives.

    + You will build deep relationship and collaborate with distribution partners to ensure customer expectations are considered and addressed. You will also review and resolve more complex escalated issues and concerns.

    **What we’re looking for**

    _Must-have experience (required):_

    + 4 year Bachelor’s degree or equivalent work experience (4 years of experience in lieu of Bachelor’s)

    + 2+ years of managerial, supervisory, and/or demonstrated leadership experience.

    + Strong relationship management skills with internal and external clients (e.g. customers, management, peers and colleagues) with a proven ability to develop collaborative approaches.

    + Excellent organizational skills with the ability to prioritize workload and multi-task while maintaining strict attention to detail.

    + Proficiency with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)

    _Nice to have experience (preferred):_

    + Claims management experience.

    + Project management skills including the ability to coordinate and balance multiple projects in a time-sensitive environment, under pressure, and meeting deadlines.

    + Experience navigating through environments with significant change.

    + Experience in defining problems, collecting data, establishing facts and drawing valid conclusions.

    + Ability to evaluate trends in data or information.

    **What’s it like to work here?**

    At Lincoln Financial Group, we love what we do. We make meaningful contributions each and every day to empower our customers to take charge of their lives. Working alongside dedicated and talented colleagues, we build fulfilling careers and stronger communities through a company that values our unique perspectives, insights and contributions and invests in programs that empower each of us to take charge of our own future.

    **What’s in it for YOU:**

    + Clearly defined career tracks and levels to help you successfully manage your career

    + Leadership development and virtual training opportunities

    + PTO/parental leave

    + Competitive 401K and employee benefits (https://hrdirectdocs.lfg.com/misc/HR/Recruiting/BenefitsResourcesGuide.pdf)

    + Free financial counseling, health coaching and employee assistance program

    + Tuition assistance program

    + A leadership team that prioritizes your health and well-being; offering a remote work environment and flexible work hybrid situations

    + Effective productivity/technology tools and training

    **Pay Range:** $67,000 - $120,700

    Actual base pay could vary based on non-discriminatory factors including but not limited to work experience, education, location, licensure requirements, proficiency and qualifications required for the role. The base pay is just one component of Lincoln’s total rewards package for employees. In addition, the role may be eligible for the Annual Incentive Program, which is discretionary and based on the performance of the company, business unit and individual. Other rewards may include long-term incentives, sales incentives and Lincoln’s standard benefits package.

    **About The Company**

    Lincoln Financial Group helps people to plan, protect and retire with confidence. As of Dec. 31, 2023, approximately 17 million customers trust our guidance and solutions across four core businesses – annuities, life insurance, group protection and retirement plan services. As of December 31, 2023, the company had $295 billion in end-of-period account balances, net of reinsurance. Headquartered in Radnor, Pa., Lincoln Financial Group is the marketing name for Lincoln National Corporation (NYSE: LNC) and its affiliates. Learn more at LincolnFinancial.com.

    Lincoln is committed to creating a diverse and inclusive (https://www.lfg.com/public/aboutus/companyoverview/diversityinclusion?audience\_page\_id=1422918942386) environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

    Follow us on Facebook (http://www.facebook.com/lincolnfinancialgroup) , X (https://mobile.twitter.com/lincolnfingroup) , LinkedIn (https://www.linkedin.com/company/4307?trkInfo=tas%3Alincoln+financial%2Cidx%3A3-1-3&trk=tyah) , and Instagram (https://www.instagram.com/lincolnfingroup/) . For the latest company news, visit our newsroom (https://www.lincolnfinancial.com/public/aboutus/newsroom) .

    **Be Aware of Fraudulent Recruiting Activities**

    If you are interested in a career at Lincoln, we encourage you to review our current openings and apply on our website. Lincoln values the privacy and security of every applicant and urges all applicants to diligently protect their sensitive personal information from scams targeting job seekers. These scams can take many forms including fake employment applications, bogus interviews and falsified offer letters.

    Lincoln will not ask applicants to provide their social security numbers, date of birth, bank account information or other sensitive information in job applications. Additionally, our recruiters do not communicate with applicants through free e-mail accounts (Gmail, Yahoo, Hotmail) or conduct interviews utilizing video chat rooms. We will never ask applicants to provide payment during the hiring process or extend an offer without conducting a phone, live video or in-person interview. Please contact Lincoln's fraud team at [email protected] if you encounter a recruiter or see a job opportunity that seems suspicious.

    **Additional Information**

    This position may be subject to Lincoln’s Political Contribution Policy. An offer of employment may be contingent upon disclosing to Lincoln the details of certain political contributions. Lincoln may decline to extend an offer or terminate employment for this role if it determines political contributions made could have an adverse impact on Lincoln’s current or future business interests, misrepresentations were made, or for failure to fully disclose applicable political contributions and or fundraising activities.

    Any unsolicited resumes/candidate profiles submitted through our web site or to personal e-mail accounts of employees of Lincoln Financial Group are considered property of Lincoln Financial Group and are not subject to payment of agency fees.

    Lincoln Financial Group (“LFG”) is an Equal Opportunity employer and, as such, is committed in policy and practice to recruit, hire, compensate, train and promote, in all job classifications, without regard to race, color, religion, sex (including pregnancy), age, national origin, disability, sexual orientation, gender identity and expression, Veteran status, or genetic information. Applicants are evaluated on the basis of job qualifications. If you are a person with a disability that impedes your ability to express your interest for a position through our online application process, or require TTY/TDD assistance, contact us by calling 260-455-2558.

    This Employer Participates in E-Verify. See the E-Verify (https://www.e-verify.gov) notices.

    Este Empleador Participa en E-Verify. Ver el E-Verify (https://www.e-verify.gov/es) avisos.

    Lincoln Financial Group ("LFG") is an Equal Opportunity employer and, as such, is committed in policy and practice to recruit, hire, compensate, train and promote, in all job classifications, without regard to race, color, religion, sex (including pregnancy), age, national origin, disability, sexual orientation, gender identity and expression, veterans status, or genetic information. Opportunities throughout LFG are available to employees and applicants and are evaluated on the basis of job qualifications. We have a drug free work environment and we perform pre-employment substance abuse testing.


    Employment Type

    Full Time

  • Life Science Claim Specialist (REMOTE US)
    Sedgwick    Phoenix, AZ 85067
     Posted 3 days    

    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

    A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

    Great Place to Work®

    Most Loved Workplace®

    Forbes Best-in-State Employer

    Life Science Claim Specialist (REMOTE US)

    **PRIMARY PURPOSE** **:** To analyze complex claims specific to the product liability / life sciences field; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within Company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service.

    **ESSENTIAL FUNCTIONS and RESPONSIBILITIES**

    + Analyzes and processes complex or technically difficult product liability / life sciences claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.

    + Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions.

    + Negotiates claim settlement up to designated authority level.

    + Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life.

    + Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement.

    + Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines.

    + Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients.

    + Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost.

    + Represents Company in depositions, mediations, and trial monitoring as needed.

    + Communicates claim activity and processing with the client; maintains professional client relationships.

    + Ensures claim files are properly documented and claims coding is correct.

    + Refers cases as appropriate to supervisor and management.

    + Delegates work and mentors assigned staff.

    **ADDITIONAL FUNCTIONS and RESPONSIBILITIES**

    + Performs other duties as assigned.

    + Supports the organization's quality program(s).

    **QUALIFICATIONS**

    **Education & Licensing**

    Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certification as applicable to line of business preferred.

    **Experience**

    Eight (8) years of claims management experience or equivalent combination of education and experience required.

    **Skills & Knowledge**

    + In-depth knowledge of product liability / life sciences insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as applicable to line-of-business

    + Excellent oral and written communication, including presentation skills

    + PC literate, including Microsoft Office products

    + Analytical and interpretive skills

    + Strong organizational skills

    + Excellent negotiation skills

    + Good interpersonal skills

    + Ability to work in a team environment

    + Ability to meet or exceed Performance Competencies

    **WORK ENVIRONMENT**

    When applicable and appropriate, consideration will be given to reasonable accommodations.

    **Mental** **:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

    **Physical** **:** Computer keyboarding, travel as required

    **Auditory/Visual** **:** Hearing, vision and talking

    **NOTE** **:** Credit security clearance, confirmed via a background credit check, is required for this position.

    _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is_ **_$100,000- $115,000._** _A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._

    The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

    Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

    **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**


    Employment Type

    Full Time


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