Claims Examiner at Sedgwick analyzing and processing complex workers' compensation claims. Managing claims resolution, negotiating settlements, and maintaining client relationships.
About the role
- Workers Comp Senior Claims Representative managing claims for a leading commercial transportation insurer. Evaluating compensability, negotiation settlements, and ensuring timely claims resolution.
Responsibilities
- Manages an inventory of claims to evaluate compensability/liability
- Plans and conducts claim investigations to confirm coverage and to determine liability, compensability and damages
- Determines and negotiates appropriate claim settlements/reserves within prescribed authority
- May attend arbitrations, mediations, depositions, or trials
- Conveys moderately complex information regarding coverage and settlements to insureds, claimants, and external partners
- Authorizes payments in accordance with assigned authority limit and ensures payments are made in a timely manner
- Maintains accurate and detailed claim files, including all correspondence, reports, and settlement agreements
- Performs other duties as assigned.
Requirements
- Bachelor’s Degree in Business Administration, Risk Management and Insurance, Finance, or a related field or equivalent experience
- 5 years of experience in property and casualty claims handling
- Completion of or continuing progress toward a professional designation preferred, such as Associate in Claims (AIC)
- Prefer PA NJ MA state handling experience
- Strong analytical, negotiation, and problem-solving skills
- Knowledge of insurance policies, coverage, and claims handling procedures
- Knowledge of industry laws and regulations
- Ability to organize and prioritize caseloads, ensuring timely resolution of claims
- Excellent interpersonal and communication skills with the ability to build relationships and lead negotiations
- Ability to handle confidential information with discretion.
Benefits
- medical, dental, and vision coverage
- wellness plans
- parental leave
- adoption assistance
- tuition reimbursement
- Paid Time Off
- paid holidays
- 401(k) plan with company match
- employee stock purchase plan
- commuter benefits
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