Claims Examiner, Auto | Recovery | Remote

Sedgwick

2d•$60,000 - $65,000•Remote

About The Position

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Examiner, Auto | Recovery | Remote PRIMARY PURPOSE: Analyzes and processes complex claims, works with high exposure claims involving litigation, and ensures ongoing claims within service expectations, industry best practices and specific client service requirements. Identifies and pursues potential third-party subrogation recoveries associated with highest exposure/complexity claims, all lines of business across all jurisdictions. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Reviews high exposure, complex multi-jurisdictional claims to establish potential for third party subrogation recovery by investigating and gathering information based on feasibility of recovery analysis and employment of strategies to manage the claim through timely resolution. Provides subrogation guidance and direction to both internal and external stakeholders to maximize recovery efforts in alignment with client, financial and jurisdictional strategy, and guidelines. Develops and pursues third party subrogation, refers assignments to subrogation counsel as dictated by statute or timeline, and discusses any compromised or negotiation of the claimed subrogation interest. Sends appropriate subrogation lien notifications to appropriate parties. Gathers information necessary to support viable subrogation claims; documents claim notes with appropriate information. Provides direction to assigned subrogation counsel. Maintains a diary on active claims with subrogation potential and claims that meet excess reporting criteria; ensures claim files are properly documented and claims coding is correct. Approves and makes timely claim payments relative to subrogation and settles complex/high exposure claims within designated client authority level. Manages claim recoveries, including but not limited to subrogation; secures recovery from responsible parties; enters recovery fees into claims management system. Prepares status reports for clients as required and presents in claims reviews. Provides additional layer subrogation expertise to peers and participates in team preparation for client reviews. Manages the litigation process; ensures timely and cost-effective resolution. Coordinates vendor referrals for additional investigation and/or litigation management. Develops training material and leads department training opportunities. Uses appropriate cost containment techniques, including strategic vendor partnerships, to reduce overall cost of claims for our clients. Assists in gathering important compliance/claims processing information to be presented at team meetings. Provides mentorship and training to colleagues within unit. ADDITIONAL FUNCTIONS and RESPONSIBILITIES Performs other duties as assigned. Travels as required.

Requirements

Bachelor's degree from an accredited college or university preferred.
Licenses as required.
Professional certification as applicable to line of business preferred.
Six (6) years of multi-jurisdictional liability (general liability, auto liability, products), subrogation and/or workers compensation claims handling experience or equivalent combination of education and experience required.
Thorough knowledge of claims management processes and procedures
Excellent oral and written communication
PC literate, including Microsoft Office products
Strong organizational skills
Excellent interpersonal skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies

Responsibilities

Reviews high exposure, complex multi-jurisdictional claims to establish potential for third party subrogation recovery by investigating and gathering information based on feasibility of recovery analysis and employment of strategies to manage the claim through timely resolution.
Provides subrogation guidance and direction to both internal and external stakeholders to maximize recovery efforts in alignment with client, financial and jurisdictional strategy, and guidelines.
Develops and pursues third party subrogation, refers assignments to subrogation counsel as dictated by statute or timeline, and discusses any compromised or negotiation of the claimed subrogation interest.
Sends appropriate subrogation lien notifications to appropriate parties.
Gathers information necessary to support viable subrogation claims; documents claim notes with appropriate information.
Provides direction to assigned subrogation counsel.
Maintains a diary on active claims with subrogation potential and claims that meet excess reporting criteria; ensures claim files are properly documented and claims coding is correct.
Approves and makes timely claim payments relative to subrogation and settles complex/high exposure claims within designated client authority level.
Manages claim recoveries, including but not limited to subrogation; secures recovery from responsible parties; enters recovery fees into claims management system.
Prepares status reports for clients as required and presents in claims reviews.
Provides additional layer subrogation expertise to peers and participates in team preparation for client reviews.
Manages the litigation process; ensures timely and cost-effective resolution.
Coordinates vendor referrals for additional investigation and/or litigation management.
Develops training material and leads department training opportunities.
Uses appropriate cost containment techniques, including strategic vendor partnerships, to reduce overall cost of claims for our clients.
Assists in gathering important compliance/claims processing information to be presented at team meetings.
Provides mentorship and training to colleagues within unit.
Performs other duties as assigned.
Travels as required.