Claims Processor - Administration

Fortune Best Workplaces in Financial Services & Insurance

Claims Representative, Recovery

PRIMARY PURPOSE OF THE ROLE: 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.

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.

Gathers information necessary to support viable subrogation claims; documents claim notes with appropriate information.

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; enters recovery fees into claims management system.

Prepares status reports for clients as required and presents in claims reviews.

Manages the litigation process; 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.

Education & Experience: 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.

Bachelor's degree from an accredited college or university preferred. PC literate, including Microsoft Office products

Computer keyboarding

Auditory/visual: 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. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. 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.