Talent.com
Claims Examiner, Bodily Injury | Liability | Remote
Claims Examiner, Bodily Injury | Liability | RemoteSan Antonio Staffing • San Antonio, TX, US
Claims Examiner, Bodily Injury | Liability | Remote

Claims Examiner, Bodily Injury | Liability | Remote

San Antonio Staffing • San Antonio, TX, US
4 days ago
Job type
  • Full-time
  • Remote
Job description

Claims Examiner, Bodily Injury | Liability | Remote

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

Primary Purpose : To analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.

Essential Functions and Responsibilities :

  • Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly.
  • Responsible for litigation process on litigated claims.
  • Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims.
  • Reports large claims to excess carrier(s).
  • Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.
  • Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage.
  • Communicates claim action / processing with insured, client, and agent or broker when appropriate.

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 from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Secure and maintain the state adjusting licenses as required for the position.

    Experience : Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws.

    Skills & Knowledge :

  • In-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws.
  • Knowledge of medical terminology for claim evaluation and Medicare compliance.
  • Knowledge of appropriate application for deductibles, sub-limits, SIR's, carrier and large deductible programs.
  • Strong oral and written communication, including presentation skills.
  • PC literate, including Microsoft Office products.
  • Strong organizational skills.
  • Strong interpersonal skills.
  • Good negotiation skills.
  • Ability to work in a team environment.
  • Ability to meet or exceed service expectations.
  • Work Environment : When applicable and appropriate, consideration will be given to reasonable accommodations.

    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 _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 $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.

    Create a job alert for this search

    Claim Examiner • San Antonio, TX, US

    Related jobs
    AVP, Claims Litigation Operations

    AVP, Claims Litigation Operations

    USAA Careers • San Antonio, Texas, United States
    Full-time
    Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for th...Show more
    Last updated: 14 hours ago • Promoted • New!
    Workers' Compensation Claims Adjuster

    Workers' Compensation Claims Adjuster

    Argonaut Management Services, Inc • San Antonio, TX, United States
    Full-time
    Argo Group International Holdings, Inc.American National, US based specialty P&C companies, (together known as BP&C, Inc. Brookfield Wealth Solutions, Ltd.BWS"), a New York and Toronto-listed public...Show more
    Last updated: 30+ days ago • Promoted
    Guidewire claims center

    Guidewire claims center

    Syntricate Technologies • San Antonio, TX, United States
    Full-time
    Position- Guidewire claims center.Associate should be able to work on Guidewire claims center integration, should be able to write programs in GOSU programming language and should work on integrati...Show more
    Last updated: 30+ days ago • Promoted
    General Liability Claims Consultant

    General Liability Claims Consultant

    The Hartford • San Antonio, TX, US
    Full-time
    We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and t...Show more
    Last updated: 3 hours ago • Promoted • New!
    AVP, Claims Litigation Operations

    AVP, Claims Litigation Operations

    USAA • San Antonio, TX, US
    Full-time
    At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military...Show more
    Last updated: 3 hours ago • Promoted • New!
    Claims Litigation Manager- Auto

    Claims Litigation Manager- Auto

    USAA • SAN ANTONIO, Texas, United States
    Full-time
    At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military...Show more
    Last updated: 2 days ago • Promoted
    Guidewire claim center

    Guidewire claim center

    CData Software • San Antonio, TX, United States
    Full-time
    Guidewire claim center integration / configuration experience.Good to have Ace certification, must have Guidewire developer associate certification.Show more
    Last updated: 4 days ago • Promoted
    Adjudicator, Provider Claims-On The Phone (Remote)

    Adjudicator, Provider Claims-On The Phone (Remote)

    San Antonio Staffing • San Antonio, TX, US
    Remote
    Full-time
    The Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims, coordinating, investigating, and confirming the appropriate resolution of claims issues.This...Show more
    Last updated: 18 days ago • Promoted
    Guidewire Claim Center Consultant

    Guidewire Claim Center Consultant

    Syntricate Technologies • San Antonio, TX, United States
    Full-time
    Required Skills : 8+ Year experience.Associate should be able to work on Guidewire claims center integration, should be able to write programs in GOSU programming language and should work on integra...Show more
    Last updated: 30+ days ago • Promoted
    Remote Licensed Property & Casualty Insurance Agent

    Remote Licensed Property & Casualty Insurance Agent

    MCI • San Antonio, TX, US
    Remote
    Full-time
    MCI is a leading Business Process Outsourcing (BPO) company that specializes in delivering tailored solutions to meet the diverse needs of our clients. With a commitment to excellence and a focus on...Show more
    Last updated: 28 days ago • Promoted
    Senior Environmental Claims Adjuster (CONTRACT)

    Senior Environmental Claims Adjuster (CONTRACT)

    Argonaut Management Services, Inc • San Antonio, TX, United States
    Full-time
    Argo Group International Holdings, Inc.American National, US based specialty P&C companies, (together known as BP&C, Inc. Brookfield Wealth Solutions, Ltd.BWS"), a New York and Toronto-listed public...Show more
    Last updated: 30+ days ago • Promoted
    Claims Analyst

    Claims Analyst

    University Health • San Antonio, Texas, United States
    Full-time
    POSITION SUMMARY / RESPONSIBILITIES Analyze complex problems pertaining to claim payments, eligibility, other insurance, transplants and system issues that are beyond the scope of claim examiners and...Show more
    Last updated: 2 days ago • Promoted
    Workers' Compensation Claims Adjuster (CONTRACT)

    Workers' Compensation Claims Adjuster (CONTRACT)

    Argonaut Management Services, Inc • San Antonio, TX, United States
    Full-time
    Argo Group International Holdings, Inc.American National, US based specialty P&C companies, (together known as BP&C, Inc. Brookfield Wealth Solutions, Ltd.BWS"), a New York and Toronto-listed public...Show more
    Last updated: 30+ days ago • Promoted
    Senior Workers' Compensation Claims Adjuster

    Senior Workers' Compensation Claims Adjuster

    Argonaut Management Services, Inc • San Antonio, TX, United States
    Full-time
    Argo Group International Holdings, Inc.American National, US based specialty P&C companies, (together known as BP&C, Inc. Brookfield Wealth Solutions, Ltd.BWS"), a New York and Toronto-listed public...Show more
    Last updated: 30+ days ago • Promoted
    General Liability Property Damage Claims Manager

    General Liability Property Damage Claims Manager

    Argonaut Management Services, Inc • San Antonio, TX, United States
    Full-time
    Argo Group International Holdings, Inc.American National, US based specialty P&C companies, (together known as BP&C, Inc. Brookfield Wealth Solutions, Ltd.BWS"), a New York and Toronto-listed public...Show more
    Last updated: 30+ days ago • Promoted
    Senior Technical Claims Specialist

    Senior Technical Claims Specialist

    Argonaut Management Services, Inc • San Antonio, TX, United States
    Full-time
    Argo Group International Holdings, Inc.American National, US based specialty P&C companies, (together known as BP&C, Inc. Brookfield Wealth Solutions, Ltd.BWS"), a New York and Toronto-listed public...Show more
    Last updated: 2 days ago • Promoted
    Claims Examiner

    Claims Examiner

    University Health • San Antonio, Texas
    Full-time
    Quick Apply
    We are looking for an experienced.POSITION SUMMARY / RESPONSIBILITIES.Performs adjudication of medical (HCFA) or hospital (UB92) claims for Medicaid, Commercial, and CHIP (Children’s Health Ins...Show more
    Last updated: 30+ days ago
    Priority Claims Specialist III

    Priority Claims Specialist III

    Hanger • San Antonio, TX, US
    Part-time
    Priority Claims Specialist III - Remote.With a mantra of Empowering Human Potential, Hanger, Inc.O&P) services and products, offering the most advanced O&P solutions, clinically differentiated prog...Show more
    Last updated: 28 days ago • Promoted