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Claims Representative - Liability | GL | Jurisdiction: LA | Licensing: LA
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Full-time
bachelor degree
Work-life balance
Posted 14d ago
~40 hrs/week
Responsibilities
The Claims Representative processes low-level general liability claims by gathering information, determining liability, and assigning reserve values. They are also responsible for negotiating settlements, managing action plans, and ensuring accurate documentation of claim files.
Requirements
The role requires at least two years of claims management experience or equivalent education and training. A bachelor's degree from an accredited college or university is preferred.
Full job description
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
Claims Representative - Liability | GL | Jurisdiction: LA | Licensing: LA
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?
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.
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.
WORK LOCATIONS: Hybrid work schedule if within 25 miles of the Baton Rouge, LA office, if outside of this radius remote work location will be explored.
PRIMARY PURPOSE OF THE ROLE :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.
ESSENTIAL RESPONSIBLITIES MAY INCLUDE
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.
Performs other duties as assigned, Supports the organization's quality program(s), Travels as required.
QUALIFICATIONS
Education & Licensing: High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.
Experience: 2 years of claims management experience or equivalent combination of education and experience required.
Licensing / Jurisdiction Knowledge: LA
TAKING CARE OF YOU
Flexible work schedule.
Referral incentive program.
Career development and promotional growth opportunities.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
WORK ENVIRONMENT REQUIREMENTSINCLUDE 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.
#claimsexaminer #claims #hybrid #LI-REMOTE
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, helping 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.
Offices: 60 Fenchurch Street, London, England EC3M 4AD, GB · 5-6 Esplande Charles de Gaulle, Nanterre, FR
claims managementrisk managementworkers' compensationdisabilityabsence solutionsaffinityfirst and third party fleet programshealthcare risk managementretail and consumer care servicesintegrated services
How many Management & Leadership jobs are open in Baton Rouge, LA right now?
There are currently 688 open management & leadership positions in Baton Rouge, LA listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Management & Leadership roles in Baton Rouge, LA?
Companies currently hiring include FMOL Health, Domino's, Ochsner Health, Kiewit, CVS Health, among others. Browse the listings above to see every active employer.
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