Claims Examiner at Sedgwick analyzing and processing complex workers' compensation claims. Managing claims resolution, negotiating settlements, and maintaining client relationships.
About the role
- Senior Claims Examiner managing complex Commercial Entertainment claims across the United States for Arch Insurance Group. Responsibilities include investigation, evaluation, and resolution of high-severity cases.
Responsibilities
- Proactively investigate, evaluate, and resolve entertainment-related claims, including film, television, live events, and touring productions.
- Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary, as well as review coverage counsel's opinion letters and analysis.
- Develop and implement strategies to address coverage issues that align with the overall approach for matters assigned to the handler.
- Develop and implement timely and accurate resolution strategies to ensure mitigation of indemnity and expense exposures.
- Maintain contact with any/all associated claims carrier(s)’ claims staff, business line leader, underwriter, defense counsel, program manager, and broker to communicate developments and outcomes as necessary.
- Investigate claims and review the insureds' materials, pleadings, and other relevant documents.
- Identify and review each jurisdiction's applicable statutes, rules, and case law.
- Review litigation materials including depositions and expert's reports.
- Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues.
- Retain counsel when necessary and direct counsel in accordance with resolution strategy.
- Analyze coverage, liability and damages for purposes of assessing and recommending reserves.
- Prepare and present written/oral reports to senior management setting forth all issues influencing evaluations and recommending reserves.
- Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter.
- Negotiate resolution of claims.
- Select and utilize structure brokers.
- Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims.
Requirements
- Bachelor’s degree required
- Seven to ten (7-10) years of working experience with a primary and/or excess carrier supporting commercial accounts for Casualty Entertainment claims.
- Proper & active adjuster licensing in all applicable states
- Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills
- Strong time management and organizational skills
- Demonstrated ability to take part in active strategic discussions
- Demonstrated ability to work well independently and in a team environment
- Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word.
- Willing and able to travel 10%.
Benefits
- multiple medical plans plus dental, vision and prescription drug coverage
- competitive 401k with generous matching
- PTO beginning at 20 days per year
- up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer
- basic Life and AD&D Insurance as well as Short and Long-Term Disability
- Paid Parental Leave of up to 10 weeks
- Student Loan Assistance and Tuition Reimbursement
- Backup Child and Elder Care
- and more.
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