Description

By 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 Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Claims Examiner, Auto | Recovery | Remote

PRIMARY PURPOSE OF THE ROLE: Analyzes and processes complex claims, works with high exposure claims involving litigation, and ensures ongoing claims within service expectations, industry best practices and specific client service requirements. Identifies and pursues potential third-party subrogation recoveries associated with highest exposure/complexity claims, all lines of business across all jurisdictions.

ARE YOU AN IDEAL CANDIDATE? We are seeking experienced professionals to manage high-exposure, complex claims with a focus on identifying and maximizing third-party subrogation recovery. Ideal candidates bring strong analytical skills, sound judgment, and the ability to collaborate effectively to drive timely, cost-effective outcomes.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Reviews high exposure, complex multi-jurisdictional claims to establish potential for third party subrogation recovery by investigating and gathering information based on feasibility of recovery analysis and employment of strategies to manage the claim through timely resolution.
• Provides subrogation guidance and direction to both internal and external stakeholders to maximize recovery efforts in alignment with client, financial and jurisdictional strategy, and guidelines.
• Develops and pursues third party subrogation, refers assignments to subrogation counsel as dictated by statute or timeline, and discusses any compromised or negotiation of the claimed subrogation interest.
• Sends appropriate subrogation lien notifications to appropriate parties.
• Gathers information necessary to support viable subrogation claims; documents claim notes with appropriate information.
• Provides direction to assigned subrogation counsel.
• Maintains a diary on active claims with subrogation potential and claims that meet excess reporting criteria; ensures claim files are properly documented and claims coding is correct.
• Approves and makes timely claim payments relative to subrogation and settles complex/high exposure claims within designated client authority level.
• Manages claim recoveries, including but not limited to subrogation; secures recovery from responsible parties; enters recovery fees into claims management system.
• Prepares status reports for clients as required and presents in claims reviews.
• Provides additional layer subrogation expertise to peers and participates in team preparation for client reviews.
• Manages the litigation process; ensures timely and cost-effective resolution.
• Coordinates vendor referrals for additional investigation and/or litigation management.
• Uses appropriate cost containment techniques, including strategic vendor partnerships, to reduce overall cost of claims for our clients.
• Assists in gathering important compliance/claims processing information to be presented at team meetings.
• Performs other duties as assigned.
• Travels as required.

QUALIFICATIONS

Education & Licensing: Six (6) years of multi-jurisdictional liability (general liability, auto liability, products), subrogation and/or workers compensation claims handling experience or equivalent combination of education and experience required.

• Bachelor's degree from an accredited college or university preferred. Licenses as required.
• Professional certification as applicable to line of business preferred.
• Adjusters License in candidate home state or other reciprocals required

TAKING CARE OF YOU

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

Work environment requirements include -
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $60,000 to $65,000 . A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

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 Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.
Requisition #: R71766

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