Claims Examiner III, Liability - Minneapolis, MN

 

CLAIM YOUR FUTURE AS A GREAT PERFORMER!
 

Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities.  We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment.  We are proud to have been recently voted the Best TPA in America and the first and only Third Party Administrator to receive the coveted Employer of Choice? designation.  Come be a part of our team and "Claim Your Future."


PRIMARY PURPOSE: To analyze complex general liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within company standards, industry best practices and specific client service requirements; and to manage subrogation of claims and negotiate settlements.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Analyzes and processes general liability claims by investigating and gathering information to determine the exposure on the claim. Assesses liability and resolves claims within evaluation. Negotiates settlement of claims up to designated authority level and makes claim payments. Processes complex or technically difficult claims. Calculates and assigns timely and appropriate reserves to claims and continues to monitor reserve adequacy throughout the life of the claim. Coordinates vendor referrals for additional investigation and/or litigation management; assigns reserve values to claims and monitors reserve adequacy. Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients. Manages claim recoveries of all types, including but not limited to subrogation. Reports claims to the excess carrier. Frequently communicates claim activity and processing with the ill or injured party and the client. Refers cases as appropriate to supervisor and management. Maintains professional client relationships. Maintains a quality assurance program to support the Total Performance Management initiative and the consistent delivery of quality claims service.

Education & Licensing:

Baccalaureate degree from an accredited college or university preferred
Licenses as required
Professional certification as applicable to Liability preferred


Experience: Five (5) years of Liability claims management experience required


 


Skills & Knowledge:

Thorough knowledge of appropriate insurance principles and laws for Liability claims management

Recoveries offsets and deductions
Claim duration
Cost containment principles and understanding of legal regulations as they apply to Liability
Excellent oral and written communication skills, including presentation skills
PC literate, including Microsoft Office products
Effective analytical and interpretive skills
Strong organizational skills
Persuasive negotiating skills
Good interpersonal skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies


Sedgwick CMS is an Equal Opportunity Employer