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Sedgwick
Sedgwick
H1B Visa SponsorConstructionConsultingHealthcare
Sedgwick provides technology-enabled risk, benefits, and integrated business solutions for organizations worldwide. Its work includes administering accident, health, disability, unemployment compensation, and liability claims, alongside building consulting, forensic accounting, forensic engineering, property restoration, brand protection, and loss prevention services. Sedgwick supports clients across industries including construction, consulting, healthcare, agriculture, and environmental services, with a stated focus on diversity, equity, inclusion, and environmental, social, and governance practices.
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Remote Liability Claims Adjuster — Sedgwick

Manage mid- and higher-level general liability claims for Sedgwick, from liability evaluation and adjudication through subrogation and settlement negotiations.

USUnited StatesRemoteFull-timeMiddleSeniorEnglish RequiredClaims Specialist

Description

  • Review general liability claims at mid and higher levels to determine benefits due.
  • Adjudicate claims in line with company standards and industry best practices.
  • Identify subrogation opportunities and negotiate settlements.
  • Gather information to evaluate liability exposure.
  • Set reserve values and issue claim payments as needed.
  • Settle claims within the assigned authority level.
  • Evaluate liability and resolve claims within the assessed valuation.
  • Approve and process assigned claims and determine benefits due.
  • Manage action plans under the claim or client contract.
  • Communicate claim actions to claimants and clients.
  • Maintain accurate claim files and coding.
  • Process complex lifetime or defined-period medical claims when applicable.
  • Build and maintain professional client relationships.
  • Support organizational quality programs.
  • Carry out other assigned duties.

Requirements

  • A bachelor's degree from an accredited college or university is preferred.
  • At least four years of claims management experience, or an equivalent combination of education and experience, is required.
  • Expertise in the insurance principles and laws relevant to the applicable line of business.
  • Knowledge of recoveries, offsets and deductions, claim and disability duration, and cost containment principles.
  • Knowledge of medical management practices and, where applicable, Social Security and Medicare procedures.
  • Strong oral and written communication skills, including presentation ability.
  • Computer proficiency, including Microsoft Office.
  • Strong analytical and interpretive skills.
  • Strong organizational skills.
  • Effective interpersonal skills.
  • Strong negotiation skills.
  • Ability to work collaboratively in a team.
  • Ability to meet or exceed service expectations.
  • Ability to manage work-related stress and multiple priorities.
  • Ability to meet deadlines.
  • Willingness to travel as required.

Benefits

  • Work-life balance.
  • Equal opportunity employer.
  • Drug-free workplace.
  • Reasonable accommodations where applicable and appropriate.
  • May be considered for other roles if experience is not an exact match.

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