(Remote) Claims Representative - Liability

Company: Sedgwick
Location: Saint Louis
Posted on: November 25, 2022

Job Description:

**The 'Apply with SEEK' option will be utilized for International applicants, mainly Australia. If this does not apply to you please use the 'Apply' option.**



(Remote) Claims Representative - Liability



IF YOU CARE, THERE'S A PLACE FOR YOU HERE



For a career path that is both challenging and rewarding, join Sedgwick's talented team of 27,000 colleagues around the globe. Sedgwick is a leading provider of technology-enabled risk, benefits and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. Whether they have a workplace injury, suffer property or financial loss or damage from a natural or manmade disaster, are involved in an auto or other type of accident, or need time away from work for the birth of a child or another medical situation, we are here to provide compassionate care and expert guidance. Our clients depend on our talented colleagues to take care of their most valuable assets-their employees, their customers and their property. At Sedgwick, caring counts -. Join our team of creative and caring people of all backgrounds, and help us make a difference in the lives of others.



With one of the largest teams of liability experts in the world, Sedgwick supports and resolves property, general, auto, product and professional liability claims. We help our clients maintain brand protection in times of crisis.



**PRIMARY PURPOSE** : To process low 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 with general supervision.



**BENEFITS**



Competitive salary



Flexible work schedule



Referral Incentive Program



Opportunity to work from home



Internal career progression and development



Benefits eligibility and 401(k) with company match day 1



**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**



+ Processes low 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.



+ Develops and coordinates low level general liability claims' action plans to resolution, return-to-work efforts, and approves claim payments.



+ Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.



+ Administers 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 low-level 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 and RESPONSIBILITIES**



+ Performs other duties as assigned.



+ Supports the organization's quality program(s).



+ Travels as required.



**QUALIFICATIONS**



**Education & Licensing**



Bachelor's degree from an accredited college or university preferred.



**Experience**



Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.



**Skills & Knowledge**



+ Developing knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure 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



+ 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



**NOTE** : Credit security clearance, confirmed via a background credit check, is required for this position.



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. #LI-Remote



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



**Taking care of people is at the heart of everything we do. Caring counts**



Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Keywords: Sedgwick, St. Louis , (Remote) Claims Representative - Liability, Other , Saint Louis, Missouri