Claims Representative role in training for workers' compensation at Sedgwick. Involves investigation and resolution of claims with ongoing professional development.
About the role
- Claims Representative II managing moderate-to-complex bodily injury and general liability claims. Investigating losses, determining liability, and negotiating settlements in various states of the US.
Responsibilities
- Settles mildly complex claims by determining insurance carrier’s liability and reaches agreement with claimant according to policy provisions and authority level.
- May be involved with litigation by analyzing negotiated settlement options; evaluating evidence, and overseeing attorney in the handling of discovery and settlement.
- Handles mediations, arbitrations, subrogation, and recorded settlement agreements.
- Determines coverage through investigations by examining claim forms, policies, and other records; interviewing claimants, insureds, and witnesses; consulting police and hospital records; inspecting damages; and consulting with experts when appropriate.
- Mentors and trains claims representatives in claims expertise by assisting in identifying training needs and opportunities.
- Resolves questionable claims by investigating the claim and comparing claims information with evidence.
- Ensures proper file documentation of assigned files by complying with company and state requirements.
- Prepares reports by collecting, analyzing, and summarizing claim information.
- Contributes to team effort (as needed) by participating on catastrophe teams; participating in determining department investigation guidelines; providing feedback to underwriting as needed.
Requirements
- Bachelor’s Degree and 3+ years of claims handling experience OR 5+ years of claims handling experience
- Proficiency in general liability claims demonstrated through knowledge and experience in insurance policies and coverage
- claim payment procedures
- insurance regulations
- and legal terminology.
- Ability to obtain and maintain proper licensing prior to handling a state that requires it.
- Professional insurance designations highly desirable.
- Litigation experience highly desirable.
- Experience using Guidewire Claims System highly desirable.
Benefits
- Salary with bonus plan
- health, dental, life, and vision insurance
- Traditional or Roth 401(k) Defined Contribution Plan PLUS Profit-Sharing Plan
- Company-paid holidays
- flexible scheduling
- PTO
- telecommuting options
- Career Coaching
- company-paid courses
- student loan and tuition reimbursement
- Charitable Match
- paid volunteer time
- team sponsorships
- Employee Assistance Program
- wellness initiatives/rewards
- health coaching
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Tech skills
Location requirements
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