Claims Examiner role at Sedgwick analyzing workers' compensation claims and ensuring timely adjudication. Requires 5 years of claims management experience and California workers' compensation knowledge.
About the role
- Senior Claims Representative managing workers comp claims for Vanliner Insurance Company. Responsible for handling and negotiating claim settlements in a remote or hybrid setting.
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
- Prefer NY and PA Workers Comp State Handling Experience
- Generally, a minimum of 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)
- Strong analytical, negotiation, and problem-solving skills
- Knowledge of insurance policies, coverage, and claims handling procedures
- 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
- Proven ability to handle confidential information with discretion
Benefits
- medical, dental, and vision coverage
- wellness plans
- parental leave
- adoption assistance
- tuition reimbursement
- Paid Time Off and paid holidays
- 401(k) plan with company match
- employee stock purchase plan
- commuter benefits
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