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Claims Examiner - Liability, Litigated Insurance Claims (REMOTE)

Company: Sedgwick
Location: Cincinnati
Posted on: January 26, 2023

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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