Claims Adjuster

1 week ago

Quebec Canada, Canada Sedgwick Full time

OBJECTIF PRINCIPAL : Règlement efficace des réclamations spécialisées en responsabilité générale multibranches de diverses complexités dans le cadre des normes de l'entreprise et des pratiques exemplaires de l'industrie.


FONCTIONS et RESPONSABILITÉS ESSENTIELLES

Gérer tous les aspects des réclamations en responsabilité générale, y compris l’établissement d’une couverture, que ce soit par le biais de polices principales ou excédentaires.

Mener une enquête pour inclure toutes les exigences légales ou contractuelles, afin d’évaluer la responsabilité et l’exposition.

Évaluer les dommages et gérer les réserves en fonction de l'évolution récente du dossier pour obtenir les résultats les plus probables.

Gérer toute occasion de subrogation ou d’appel d’offres.

Fournir un service client de haute qualité en communiquant avec le client et les parties impliquées.

S'assurer que les dossiers de réclamation sont correctement documentés.

Gérer les réclamations litigieuses en assistant pratiquement à toutes les procédures judiciaires. Sécuriser les budgets et évaluations de cas.

Négocier et régler les réclamations dans le cadre du pouvoir délégué.

Remplir tout rapport requis.  Entretenir des relations professionnelles avec les clients.


FONCTIONS et RESPONSABILITÉS SUPPLÉMENTAIRES

Effectuer d’autres tâches qui lui sont confiées.

Soutenir le(s) programme(s) de qualité de l’organisation.

Déplacements selon les besoins


QUALIFICATIONS

Formation et certification

Baccalauréat ou diplôme collégial préféré

Expérience

Quatre (4) ans d'expérience en gestion des réclamations ou une combinaison équivalente de formation et d'expérience est requise.

Compétences et connaissances

Expert en la matière des principes et lois d'assurance appropriés pour le secteur d'activité traité, des compensations et déductions des recouvrements, de la durée des sinistres et de l'invalidité ainsi que des principes de maîtrise des coûts

Excellente communication orale et écrite

Maîtrise d'outils informatiques, y compris des produits Microsoft Office

Compétences analytiques et interprétatives

Solides compétences organisationnelles

Bonnes compétences interpersonnelles

Excellentes compétences en négociation

Capacité à travailler dans un environnement d'équipe

Capacité à satisfaire ou dépasser les attentes en matière de service à la clientèle


Les déclarations contenues dans ce document visent à décrire la nature générale et le niveau de travail effectué par un collègue affecté à cette description. Ils ne sont pas destinés à constituer une liste exhaustive des fonctions, devoirs ou variantes locales. La direction se réserve le droit d’ajouter ou de modifier les fonctions du poste à tout moment.

Nous engageons à mettre en place des processus de recrutement et de sélection inclusifs et exempts d’obstacles. Si vous êtes contacté(e) pour une opportunité d’emploi, veuillez informer les ressources collégiales si vous avez besoin d’un accommodement.

Sedgwick est un employeur qui souscrit au principe de l’égalité des chances.

PRIMARY PURPOSE: Effective adjudication of specialized multi line general liability claims of various complexities within company standards and industry best practices.


ESSENTIAL FUNCTIONS and RESPONSIBILITIES

Manage all aspects of general liability claims to include establishing coverage whether through primary or excess policies.

Complete investigation to include any statutory or contractual requirements to assess liability and exposure.

Evaluate damages and manage reserves based on recent developments of the file for most probable outcomes.

Manage any subrogation or tender opportunities.

Provide high level of quality customer service by communication with the client and the parties involved.

Ensures claim files are properly documented.

Manage litigated claims by attending virtually to any legal proceedings. Securing budgets and case evaluations.

Negotiate and settle claims within the delegated authority.

Complete any reporting that is required.

Maintains professional client relationships.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

Performs other duties as assigned.

Supports the organization's quality program(s).

Travels as required.

QUALIFICATION

Education & Licensing

Bachelor's degree or college diploma preferred.

Experience

Four (4) years of claims management experience or equivalent combination of education and experience required.


Skills & Knowledge

Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles

Excellent oral and written communication

PC literate, including Microsoft Office products

Analytical and interpretive skills

Strong organizational skills

Good interpersonal skills

Excellent negotiation skills

Ability to work in a team environment

Ability to meet or exceed Service Expectations

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