Claims Adjuster

Claims Adjuster - Accident Benefits page is loaded## Claims Adjuster - Accident Benefitslocations: Canada Telecommutertime type: Full timeposted on: Posted 16 Days Agojob requisition id: R67146By 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 & InsuranceClaims Adjuster - Accident Benefits**PRIMARY PURPOSE**: To analyze mid- and higher-level general liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.**ESSENTIAL FUNCTIONS and RESPONSIBILITIES*** Manages mid-level general liability claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.* Assesses liability and resolves claims within evaluation.* Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.* Manages subrogation of claims and negotiates settlements.* Communicates claim action with claimant and client.* Ensures claim files are properly documented and claims coding is correct.* May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.* Maintains professional client relationships.**ADDITIONAL FUNCTIONS and RESPONSIBILITIES*** Performs other duties as assigned.* Supports the organization's quality program(s).* Travels as required.**QUALIFICATIONS****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 ExpectationsThe 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.We are committed to inclusive, barrier-free recruitment and selection processes. If contacted for an employment opportunity, please advise Colleague Resources if you require accommodation.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.locations: Canada Telecommutertime type: Full timeposted on: Posted 15 Days Ago## 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
#J-18808-Ljbffr