REMOTE POSITION / CLAIMS PROCESSOR Job at Sedgwick in Springfield
Fortune Best Workplaces in Financial Services & Insurance Litigated Claims Consultant (Examiner) | Public Entity | Remote Enjoy flexibility - This role is open to a work-at-home, remote, telecommuter setting in Ohio with some travel required. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. If you have 10+ years of experience handling high-exposure, complex claims involving serious injuries and legal inquiries or disputes, and developing strategies to bring cases to satisfactory resolution, and would like to join one of the premier teams in the industry, we are looking for someone with your level of expertise. To address and handle high end cases with serious injuries, complex coverage scenarios and legal inquiries or disputes; seeks legal opinion and early resolution; Gathers/documents additional information and coordinates with client designees. Requests legal/private investigation; assigns to and coordinates with local counsel; monitors local counsel performance. Responds to plaintiff's counsel, union, employee, or client requests. - Establishes/adjusts accrued liability and approves administrative expenses. Supports the organization's quality program(s). Bachelor's degree from an accredited college or university preferred. Ten (10) years of experience handling litigation including 5 years of claims management experience or equivalent combination of education and experience required. 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 line-of-business. Technically skilled and familiar with legal pleadings, discovery et al PC literate, including Microsoft Office products Ability to meet or exceed Performance Competencies excellent judgment, troubleshooting, problem solving, analysis, and discretion; Computer keyboarding, travel as required Auditory/Visual: Hearing, vision and talking 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. LI-REMOTE #LI-HYBRID #claimsexaminer Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. Apply tot his job