General Liability Adjuster

General Liability Adjuster

PRIMARY PURPOSE

To analyze mid- and higher-level general liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES

Manages mid-level general liability claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level. Assesses liability and resolves claims within evaluation. Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract. Manages subrogation of claims and negotiates settlements. Communicates claim action with claimant and client. Ensures claim files are properly documented and claims coding is correct. May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review. Maintains professional client relationships.

ADDITIONAL FUNCTIONS & RESPONSIBILITIES

Performs other duties as assigned. Supports the organization's quality program(s). Travels as required.

QUALIFICATION

Education & Licensing Bachelor's degree from an accredited college or university preferred. Experience Four (4) years of claims management experience or equivalent combination of education and experience required. Skills & Knowledge Subject 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. Excellent oral and written communication, including presentation skills PC literate, including Microsoft Office products Analytical and interpretive skills Strong organizational skills Good interpersonal skills Excellent negotiation skills Ability to work in a team environment Ability to meet or exceed Service Expectations

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 Job type We are currently hiring for this position Compensation Information Salary Range: $60,000 - $70,000 CAD annually Compensation is determined based on experience, qualifications, and internal equity. Sedgwick is committed to transparent and equitable pay practices. 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. We are committed to inclusive, barrier-free recruitment and selection processes. If contacted for an employment opportunity, please advise Colleague Resources if you require accommodation. Sedgwick is an Equal Opportunity Employer. #J-18808-Ljbffr Sedgwick