Lawyer Auditor

3 weeks ago


Toronto Montreal Calgary Vancouver Edmonton Old Toronto Ottawa Mississauga Quebec Winnipeg Halifax Saskatoon Burnaby Hamilton Victoria Surrey Halton Hills London Regina Markham Brampton Vaughan Kelowna Laval Southwestern Ontario R, Canada Sedgwick Claims Management Services Ltd Full time

Lawyer Auditor page is loaded## Lawyer Auditorlocations: CAN-Telecommute-ONtime type: Full timeposted on: Posted 8 Days Agojob requisition id: R67233By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top CompaniesCertified as a Great Place to WorkFortune Best Workplaces in Financial Services & InsuranceLawyer Auditor**PRIMARY PURPOSE**: To address and handle high end cases with serious injuries, complex coverage scenarios and legal inquiries or disputes; to develop a strategy to bring a case to satisfactory resolution.**ESSENTIAL FUNCTIONS and RESPONSIBILITIES*** Reviews/acts on reports/forms; responds to inquiries; seeks legal opinion and early resolution; and communicates resolution to appropriate parties.* Handles high end cases with serious injuries and/or complex coverage scenarios.* Responds to decisions, agreement, and/or court order; creates action plan; determines need for examination; gains client authorization.* Identifies cases for settlements/redemptions.* Gathers/documents additional information and coordinates with client designees.* Requests legal/private investigation; assigns to and coordinates with local counsel; monitors local counsel performance.* Responds to plaintiff's counsel, union, employee, or client requests.* Identifies issues and formulates defense strategy.* Establishes/adjusts accrued liability and approves administrative expenses.* Identifies subrogation opportunities and manages process.* Attends and participates in mediations, trials, arbitrations or hearings as needed.* Works with partners to affect early return-to-work.**ADDITIONAL FUNCTIONS and RESPONSIBILITIES*** Performs other duties as assigned.* Supports the organization's quality program(s).**QUALIFICATIONS****Education & Licensing** Bachelor's degree from an accredited college or university preferred. Juris Doctorate (JD) preferred.**Experience** Ten (10) years of experience handling litigation including 5 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 including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.* Technically skilled and familiar with legal pleadings, discovery et al* Excellent oral and written communication, including presentation skills* PC literate, including Microsoft Office products* Analytical and interpretive skills* Strong organizational skills* Excellent interpersonal skills* Excellent negotiation skills* Ability to work in a team environment* Ability to meet or exceed Performance CompetenciesThe statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.Sedgwick is an Equal Opportunity Employer.The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Sedgwick retains the discretion to add or to change the duties of the position at any time.## Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see
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