Claims Assistant

Telecommuter TX

Full time

R78075

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

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Claims Assistant

PRIMARY PURPOSE : Handles losses and claims valued up to $15,000 for property and casualty insurers through the thorough examination of documents, records, loss reports, and other relevant documentation. Efficiently manages a case load using technology for efficient claim processing.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Evaluates insurance policies, claims forms, policies, endorsements, carrier instructions, and other records to determine insurance coverage.

• Conducts thorough investigations, gathers official reports as needed, consults police and hospital records and inspects physical damage or written estimates for damages based on a conducted inspection to determine extent of company's liability and varying methods of investigation, according to type of insurance.

• Interviews, telephones, and/or corresponds with claimant and witnesses regarding claim.

• Estimates cost of repair, replacement, or compensation.

• Prepares report of findings and negotiates claim settlements by adhering to carrier instructions and obtaining necessary information. Issues settlement checks, files regulatory documents, and handles salvage and subrogation as applicable.

• Recommends litigation by legal department when settlement cannot be negotiated.

• Attends litigation hearings and participates in depositions as necessary.

• Revises case reserves in assigned claims files to cover probable costs.

• Maintains an expected caseload efficiently.

• Utilizes technology and automation tools for efficient claim handling.

• Sends claims exceeding $15,000 gross loss amount to leadership for authority approval.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred. Must obtain IIA-AIC designation within 12 to 18 months in the role. Appropriate state adjuster license is required.

Experience

Three (3) year of related experience or equivalent combination of education and experience required. Prior experience handling property and casualty claims a plus but not required.

Skills & Knowledge

• Empathetic claims handling demeanor

• Strong communication, analytical, organizational, and interpersonal skills

• PC literate, including Microsoft Office products

• Analytical and interpretive skills

• Negotiating skills

• Ability to create and complete comprehensive, accurate and constructive written reports

• Ability to work in a team environment

• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When 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 deadlines

Physical : Computer keyboarding, travel as required

Auditory/Visual : Hearing, vision and talking

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.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see sedgwick.com