Posted on: January 15, 2021
The 'Apply with SEEK' option will be utilized for International
applicants, mainly Australia. If this does not apply to you please
use the 'Apply' option.
IF YOU CARE, THERE---S A PLACE FOR YOU HERE
For a career path that is both challenging and rewarding, join
Sedgwick---s talented team of 27,000 colleagues around the globe.
Sedgwick is a leading provider of technology-enabled risk, benefits
and integrated business solutions. Taking care of people is at the
heart of everything we do. Millions of people and organizations
count on Sedgwick each year to take care of their needs when they
face a major life event or something unexpected happens. Whether
they have a workplace injury, suffer property or financial loss or
damage from a natural or manmade disaster, are involved in an auto
or other type of accident, or need time away from work for the
birth of a child or another medical situation, we are here to
provide compassionate care and expert guidance. Our clients depend
on our talented colleagues to take care of their most valuable
assets---their employees, their customers and their property. At
Sedgwick, caring counts--. Join our team of creative and caring
people of all backgrounds, and help us make a difference in the
lives of others.
With one of the largest teams of liability experts in the world,
Sedgwick supports and resolves property, general, auto, product and
professional liability claims. We help our clients maintain brand
protection in times of crisis.
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
- Manages subrogation of claims and negotiates settlements.
- Communicates claim action with claimant and client.
- Ensures claim files are properly documented and claims coding
- 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
- Maintains professional client relationships.
ADDITIONAL FUNCTIONS And RESPONSIBILITIES
- Performs other duties as assigned.
- Supports the organization's quality program(s).
- Travels as required.
Education & Licensing
Bachelor's degree from an accredited college or university
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 including medical management practices and Social
Security and Medicare application procedures as applicable to
- Excellent oral and written communication, including
- 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
When applicable and appropriate, consideration will be given to
Mental: Clear and conceptual thinking ability; excellent judgment,
troubleshooting, problem solving, analysis, and discretion; ability
to handle work-related stress; ability to handle multiple
priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
NOTE: Credit security clearance, confirmed via a background credit
check, is required for this position.
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.
Management retains the discretion to add or to change the duties of
the position at any time.
Sedgwick is an Equal Opportunity Employer and a Drug-Free
Keywords: Sedgwick, Dallas , Claims Adjuster, Other , Dallas, Texas
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