Claims Examiner - Liability, Litigated Insurance Claims (REMOTE)
Company: Sedgwick
Location: Cincinnati
Posted on: January 26, 2023
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Job Description:
The 'Apply with SEEK' option will be utilized for International
applicants, mainly Australia. If this does not apply to you please
use the 'Apply' option.Claims Examiner - Liability, Litigated
Insurance Claims (REMOTE)IF YOU CARE, THERE'S A PLACE FOR YOU
HEREFor a career path that is both challenging and rewarding, join
Sedgwick's talented team of 27,000 colleagues around the globe.
Sedgwick is a leading provider of technology-enabled risk, benefits
and integrated business solutions. Taking care of people is at the
heart of everything we do. Millions of people and organizations
count on Sedgwick each year to take care of their needs when they
face a major life event or something unexpected happens. Whether
they have a workplace injury, suffer property or financial loss or
damage from a natural or manmade disaster, are involved in an auto
or other type of accident, or need time away from work for the
birth of a child or another medical situation, we are here to
provide compassionate care and expert guidance. Our clients depend
on our talented colleagues to take care of their most valuable
assets-their employees, their customers and their property. At
Sedgwick, caring counts -. Join our team of creative and caring
people of all backgrounds, and help us make a difference in the
lives of others.With one of the largest teams of liability experts
in the world, Sedgwick supports and resolves property, general,
auto, product and professional liability claims. We help our
clients maintain brand protection in times of crisis.This role is
open to a remote, telecommute, work-at-home setting.*Insurance
claims legal experience highly desired (claims in
litigation).PRIMARY PURPOSE: To address and handle high end cases
with serious injuries, complex coverage scenarios and legal
inquiries or disputes; to develop a strategy to bring a case to
satisfactory resolution.ESSENTIAL FUNCTIONS and
RESPONSIBILITIESReviews/acts on reports/forms; responds to
inquiries; seeks legal opinion and early resolution; and
communicates resolution to appropriate parties.Handles high end
cases with serious injuries and/or complex coverage
scenarios.Responds to decisions, agreement, and/or court order;
creates action plan; determines need for examination; gains client
authorization.Identifies cases for
settlements/redemptions.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.Identifies issues and
formulates defense strategy.Establishes/adjusts accrued liability
and approves administrative expenses.Identifies subrogation
opportunities and manages process.Attends and participates in
mediations, trials, arbitrations or hearings as needed.Works with
partners to affect early return-to-work.ADDITIONAL FUNCTIONS and
RESPONSIBILITIESPerforms other duties as assigned.Supports the
organization's quality program(s).QUALIFICATIONSEducation &
LicensingBachelor's degree from an accredited college or university
preferred. Juris Doctorate (JD) preferred.ExperienceTen (10) years
of experience handling litigation including 5 years of claims
management experience or equivalent combination of education and
experience required.Skills & KnowledgeSubject 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 alExcellent oral and written
communication, including presentation skillsPC literate, including
Microsoft Office productsAnalytical and interpretive skillsStrong
organizational skillsExcellent interpersonal skillsExcellent
negotiation skillsAbility to work in a team environmentAbility to
meet or exceed Performance CompetenciesWORK ENVIRONMENTWhen
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 deadlinesPhysical: Computer keyboarding, travel as
requiredAuditory/Visual: Hearing, vision and talkingNOTE: Credit
security clearance, confirmed via a background credit check, is
required for this position.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.#LI-KN1 #LI-REMOTE*subject to change based on company
needSedgwick is an Equal Opportunity Employer and a Drug-Free
Workplace.
Keywords: Sedgwick, Cincinnati , Claims Examiner - Liability, Litigated Insurance Claims (REMOTE), Other , Cincinnati, Ohio
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