Talent.com
Claims Examiner | Auto NF, PIP, MP | Remote

Claims Examiner | Auto NF, PIP, MP | Remote

California StaffingSacramento, CA, US
7 hours ago
Job type
  • Full-time
  • Remote
Job description

Claims Examiner | Auto NF, PIP, MP | 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

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands? Enjoy flexibility and autonomy in your daily work, your location, and your career path. This role is open to a remote, telecommuter, work-at-home, or hybrid setting nationwide. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

Are You An Ideal Candidate?

As a Claims Examiner, you will primarily handle auto-related liability claims for the following lines of coverage : Auto Liability, No Fault (NF), Personal Injury Protection (PIP), and Medical Payments (MP). No two days are the same as you assist our clients with their claims! If you are an agile auto claims examiner with 5+ years of experience, we want to talk to you!

Primary Purpose Of The Role

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 $78,951 $87,428 USD annual salary. 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.

    Always accepting applications. 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

    Auto Claim Examiner • Sacramento, CA, US

    Related jobs
    • Promoted
    • New!
    Senior Claims Examiner

    Senior Claims Examiner

    California StaffingSacramento, CA, US
    Full-time
    Are you looking to make an impactful difference in your work, yourself, and your community? Why settle for just a job when you can land a career? At ICW Group, we are hiring team members who are re...Show moreLast updated: 7 hours ago
    • Promoted
    Claims Team Lead | Auto Liability Bodily Injury | Remote

    Claims Team Lead | Auto Liability Bodily Injury | Remote

    Remote StaffingSacramento, CA, US
    Remote
    Full-time
    Auto Liability Bodily Injury Claims Team Lead.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 faci...Show moreLast updated: 1 day ago
    • Promoted
    • New!
    Travel Nurse RN - Emergency Room (ER) / Trauma - $2,090 to $2,317 per week in Woodland, CA

    Travel Nurse RN - Emergency Room (ER) / Trauma - $2,090 to $2,317 per week in Woodland, CA

    TravelNurseSourceWoodland, CA, US
    Full-time
    TravelNurseSource is working with LRS Healthcare to find a qualified ER / Trauma RN in Woodland, California, 95695!.Ready to start your next travel adventure? LRS Healthcare offers a full benefits pa...Show moreLast updated: 11 hours ago
    • Promoted
    Claims Examiner

    Claims Examiner

    Lucent HealthRancho Cordova, CA, US
    Full-time
    Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that e...Show moreLast updated: 1 day ago
    • Promoted
    • New!
    Claims Team Lead | Auto Property Damage | Remote

    Claims Team Lead | Auto Property Damage | Remote

    California StaffingSacramento, CA, US
    Remote
    Full-time
    Auto Property Damage Claims Team Lead.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 u...Show moreLast updated: 7 hours ago
    • Promoted
    Claims Examiner I

    Claims Examiner I

    Astiva Health, IncSacramento, CA, United States
    Full-time
    Orange, CA is a premier healthcare provider specializing in Medicare and HMO services.With a focus on delivering comprehensive care tailored to the needs of our diverse community, we prioritize acc...Show moreLast updated: 7 days ago
    • Promoted
    • New!
    Claims Team Lead | Auto Liability Bodily Injury | Remote

    Claims Team Lead | Auto Liability Bodily Injury | Remote

    California StaffingSacramento, CA, US
    Remote
    Full-time
    Auto Liability Bodily Injury Claims Team Lead.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 faci...Show moreLast updated: 7 hours ago
    • Promoted
    • New!
    Travel Nurse RN - Emergency Room (ER) / Trauma - $2,340 per week in Davis, CA

    Travel Nurse RN - Emergency Room (ER) / Trauma - $2,340 per week in Davis, CA

    TravelNurseSourceDavis, CA, US
    Full-time
    TravelNurseSource is working with Magnet Medical to find a qualified ER / Trauma RN in Davis, California, 95616!.The Registered Nurse (RN) in the Emergency Room (ER) provides critical care to patient...Show moreLast updated: 11 hours ago
    • Promoted
    • New!
    Travel Nurse RN - Emergency Room (ER) / Trauma - $2,490 per week in Davis, CA

    Travel Nurse RN - Emergency Room (ER) / Trauma - $2,490 per week in Davis, CA

    TravelNurseSourceDavis, CA, US
    Full-time
    TravelNurseSource is working with Care Career to find a qualified ER / Trauma RN in Davis, California, 95616!.Emergency Room Nurses (RN) are responsible to treat a variety of injuries and illness bro...Show moreLast updated: 11 hours ago
    • Promoted
    Survey Taker : Earn up to $25 per survey (Remote)

    Survey Taker : Earn up to $25 per survey (Remote)

    Earn HausLinda, CA, US
    Remote
    Full-time +1
    Looking for people to participate in taking online surveys for Fortune 500 brands.All you need to do is complete online surveys by sharing your opinion. You will help influence brand decisions on se...Show moreLast updated: 8 days ago
    • Promoted
    • New!
    (Remote) Claims Examiner - Workers Compensation | California Experience

    (Remote) Claims Examiner - Workers Compensation | California Experience

    Remote StaffingSacramento, CA, US
    Remote
    Full-time
    Claims Examiner - Workers Compensation | California.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 ar...Show moreLast updated: 7 hours ago
    • Promoted
    Travel Nurse RN - Labor and Delivery - $3,100 per week

    Travel Nurse RN - Labor and Delivery - $3,100 per week

    ProKatchersMarysville, CA, United States
    Full-time
    ProKatchers is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Marysville, California.Job Description & Requirements. Night Shift, prefers 36 but if its a barrier please adv...Show moreLast updated: 22 days ago
    • Promoted
    • New!
    Travel Nurse RN - Labor & Delivery - $2,091 to $2,318 per week in Marysville, CA

    Travel Nurse RN - Labor & Delivery - $2,091 to $2,318 per week in Marysville, CA

    TravelNurseSourceMarysville, CA, US
    Full-time
    TravelNurseSource is working with LRS Healthcare to find a qualified Labor / Delivery RN in Marysville, California, 95901!. Ready to start your next travel adventure? LRS Healthcare offers a full bene...Show moreLast updated: 11 hours ago
    • Promoted
    Claims Examiner (Rancho Cordova)

    Claims Examiner (Rancho Cordova)

    Lucent HealthRancho Cordova, CA, US
    Part-time
    Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that e...Show moreLast updated: 2 days ago
    • Promoted
    • New!
    Liability Claims Examiner - Auto & GL

    Liability Claims Examiner - Auto & GL

    California StaffingRoseville, CA, US
    Full-time
    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 c...Show moreLast updated: 8 hours ago
    • Promoted
    • New!
    Senior Claims Examiner

    Senior Claims Examiner

    Arthur J Gallagher & CoRancho Cordova, CA, US
    Full-time
    At Gallagher, we help clients face risk with confidence because we believe that when businesses are protected, they're free to grow, lead, and innovate. You'll be backed by our digital ecosystem : a ...Show moreLast updated: 7 hours ago
    • Promoted
    Claims Team Lead | Auto Property Damage | Remote

    Claims Team Lead | Auto Property Damage | Remote

    Remote StaffingSacramento, CA, US
    Remote
    Full-time
    Auto Property Damage Claims Team Lead.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 u...Show moreLast updated: 1 day ago
    • Promoted
    • New!
    Travel Surgical Tech - $1,826 per week in Auburn, CA

    Travel Surgical Tech - $1,826 per week in Auburn, CA

    AlliedTravelCareersAuburn, CA, US
    Full-time
    AlliedTravelCareers is working with Triage Staffing LLC to find a qualified Surg Tech in Auburn, California, 95602!.Shift Details : 8H Days (7 : 00 AM-3 : 30 PM). Length : 13 WEEKS 13 weeks.A...Show moreLast updated: 12 hours ago