A Claims Examiner evaluates insurance claims in accordance with applicable contracts and government regulations within their insurance type. Determines member eligibility and financial responsibility of the insurance company.
Either Full or Part Time, more than 6 months
SR You may contact this employer directly.
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Job Summary Roseville, CA Telecommuter ID San Diego, CA Ontario, CA Telecommuter CA Long Beach, CA Orange, CA Telecommuter NV Brea, CA Glendale, CA West Hills, CA Telecommuter WA Riverside, CA Telecommuter OR Concord, CA Telecommuter
AZ R72696
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 Litigation Examiner - General Liability | Must Reside in CA Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands? Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights. Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. Enjoy flexibility and autonomy in your daily work, your location, and your career path. Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
ARE YOU AN IDEAL CANDIDATE?
We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
PRIMARY PURPOSE
: To address and handle high end General Liability 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
RESPONSIBILITIES
Reviews/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
RESPONSIBILITIES
Performs other duties as assigned. Supports the organization's quality program(s).
QUALIFICATIONS
Education & ... Lawyers
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Compensation
Not Provided
Job Requirements
