Talent.com
Claims Examiner, Bodily Injury | Liability | Remote
Claims Examiner, Bodily Injury | Liability | RemoteDallas Staffing • Dallas, TX, US
Claims Examiner, Bodily Injury | Liability | Remote

Claims Examiner, Bodily Injury | Liability | Remote

Dallas Staffing • Dallas, TX, US
2 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 • Dallas, TX, US

    Related jobs
    Claims Advocate - Property / Energy & Renewables - Commercial Insurance Claims

    Claims Advocate - Property / Energy & Renewables - Commercial Insurance Claims

    Aon • Dallas, TX, United States
    Full-time +1
    Aon is looking for a Property / Energy & Renewables Claims Advocate.Are you ready to take on a new challenge and work with the best Risk Management Professionals in the business? Then this just maybe...Show more
    Last updated: 30+ days ago • Promoted
    Earn up to $25 per survey Online Survey Taker - Work-from-home flexibility (Hiring Immediately)

    Earn up to $25 per survey Online Survey Taker - Work-from-home flexibility (Hiring Immediately)

    Earn Haus • Ennis, Texas, US
    Remote
    Full-time +1
    We are urgently looking for people interested in taking online surveys for Fortune 500 brands.If you are a self-starter, looking for flexible hours throughout the week, this may be for you! Earn up...Show more
    Last updated: 30+ days ago • Promoted
    Claims Specialist III

    Claims Specialist III

    INSHUR • Dallas, TX, US
    Full-time +1
    Quick Apply
    Are you keen to work somewhere that’s stimulating and friendly, with loads of opportunities for growth and plenty of freedom to make a real impact? This could be the place for you!.INSHUR! We’re ba...Show more
    Last updated: 3 days ago
    Direct Sales Representative

    Direct Sales Representative

    Dentwerks Pro • Dallas, TX, US
    Full-time
    Quick Apply
    Direct Sales Representative — Dentwerks Auto Hail Repair (Dallas–Fort Worth) Location : .Dallas, TX (50-mile territory radius across the DFW metro) Comp : Commission-plus base salary.Full-...Show more
    Last updated: 30+ days ago
    Dental Claims Examiner

    Dental Claims Examiner

    Firstsource • Dallas, TX, United States
    Full-time
    Dental Claims Examiner-Work From Home.Health Plan and Healthcare Services.Team Lead / Supervisor - Operations.The Claims Examiner evaluates insurance claims to determine whether their validity and ho...Show more
    Last updated: 4 days ago • Promoted
    Independent Dispute Resolution (IDR) Claims / OON Specialist

    Independent Dispute Resolution (IDR) Claims / OON Specialist

    Exceptional Healthcare Inc. • Dallas, TX, US
    Full-time
    Quick Apply
    We are seeking an experienced and highly motivated Independent Dispute Resolution (IDR) Claims / OON Specialist to join our team. This role requires expertise in medical billing, collection, and app...Show more
    Last updated: 30+ days ago
    Licensed Life Insurance Agent – Remote Position

    Licensed Life Insurance Agent – Remote Position

    GIA Legacy Planning • Dallas, Texas, US
    Remote
    Full-time +1
    Quick Apply
    Licensed Life Insurance Agent – Remote Position.Full-Time | Part-Time | Commission-Based.We are committed to empowering our agents with cutting-edge technology, world-class training, and a supporti...Show more
    Last updated: 30+ days ago
    Revenue Cycle Specialist

    Revenue Cycle Specialist

    Hiregy • Dallas, TX, United States
    Full-time
    JOB 22742 – Revenue Cycle Specialist.Location : Fully remote – Must be a supported work location.CA, CO, DE, IL, MA, MI, NJ, NY, OR, WA. Schedule : M-F, 8 : 00 AM to 5 : 00 PM EST.Manage complex insurance...Show more
    Last updated: 8 days ago • Promoted
    Remote Survey Participant (Hiring Immediately)

    Remote Survey Participant (Hiring Immediately)

    Earn Haus • Ennis, Texas, US
    Remote
    Full-time +1
    We are urgently looking for people interested in taking online surveys for Fortune 500 brands.If you are a self-starter, looking for flexible hours throughout the week, this may be for you! Earn up...Show more
    Last updated: 30+ days ago • Promoted
    Earn up to $25 per survey Online Survey Taker (Hiring Immediately)

    Earn up to $25 per survey Online Survey Taker (Hiring Immediately)

    Earn Haus • Ennis, Texas, US
    Full-time +1
    We are urgently looking for people interested in taking online surveys for Fortune 500 brands.If you are a self-starter, looking for flexible hours throughout the week, this may be for you! Earn up...Show more
    Last updated: 30+ days ago • Promoted
    Medical Claims Denial Management Specialist

    Medical Claims Denial Management Specialist

    Delta Dallas • Dallas, TX, United States
    Full-time
    Medical Claims Denial Management Specialist – Addison, TX.We are looking for a detail-oriented professional to review, analyze, and resolve denied or underpaid medical claims.CPT / HCPCS, ICD-10, and...Show more
    Last updated: 7 days ago • Promoted
    Licensed Life and Health Insurance Agent – Remote Position - Flexible Hours

    Licensed Life and Health Insurance Agent – Remote Position - Flexible Hours

    GIA Legacy Planning • Garland, Texas, US
    Remote
    Full-time +1
    Quick Apply
    Remote Position / Work from Home .Full-Time | Part-Time | Uncapped Commission-Based.Licensed Life and Health Insurance Agents. We are passionate about helping clients reach their financial goals and a...Show more
    Last updated: 30+ days ago
    Customer Service Manager - Claims & Loss Mitigation

    Customer Service Manager - Claims & Loss Mitigation

    Apple Roofing • Plano, TX, US
    Full-time
    Quick Apply
    At Apple Roofing, our purpose is to build a sweeter experience - for our teammates, our customers, and our partners.We do this by putting people first, making it easy, and doing the right thing.The...Show more
    Last updated: 9 days ago
    Looking for Licensed life insurance Agents – Remote position

    Looking for Licensed life insurance Agents – Remote position

    Guetterman Financial Group, LLC • Dallas, TX, US
    Remote
    Full-time
    Quick Apply
    Looking for Licensed life insurance Agents – Remote position Are you an agent who has yet to master virtual sales?.Or perhaps a great sales professional who has never been given the opportuni...Show more
    Last updated: 30+ days ago