Auto claims examiner, bodily injury

Overview

Sedgwick est l'un des principaux fournisseurs mondiaux de gestion de risques, de santé, de prévoyance et de solutions d’assurance intégrées. Dans le cadre de sa croissance et de son développement international, Sedgwick s’implante en France à travers ses activités d’expertise d’assurance. Afin d’être au plus proche et de répondre aux besoins de ses clients, Sedgwick propose des solutions et adapte son offre en fonction des évolutions actuelles et futures du marché. Nos 27 000 collègues présents dans 65 pays forts de leurs compétences et de leurs différentes cultures avancent dans un but commun : délivrer l’excellence pour nos clients et nos partenaires. En France, Sedgwick compte parmi les leaders du marché de la gestion des risques auprès de ses clients assureurs. Nos 800 collègues sont répartis sur 30 sites, afin d’assurer une présence nationale. Nous laissons part à la créativité, à l’innovation et donnons l’opportunité à nos collègues de développer leurs compétences dans un environnement propice à l’épanouissement personnel. Empathie, Responsabilité, Collaboration, Croissance et Intégration : nos valeurs fondamentales n’existent pas seulement sur papier ; elles guident notre façon de travailler au quotidien et sont la force motrice de notre succès collectif.


Position

Auto Claims Examiner, Bodily Injury


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 $75,000. 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.

Si ce poste vous intéresse mais que votre expérience ne correspond pas parfaitement à toutes les qualifications de sa description, envisagez de postuler quand même ! Sedgwick construit un lieu de travail diversifié, équitable et inclusif et considère que chaque personne possède une combinaison unique de compétences, de connaissances et d’expérience. Vous êtes peut-être le bon candidat pour ce poste ou pour d’autres.

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