Claims Examiner, Auto | Bodily Injury
- Location
- Telecommuter FL; Telecommuter NC; Telecommuter GA; Telecommuter WI
- Work mode
- On-site
- Employment type
- Full-time
Skills mentioned
- Claims analysis
- Liability assessment
- Settlement negotiation
- Reserve calculation
- Auto insurance policies
- Litigation management
- Subrogation
- Microsoft Office
- Written communication
- State adjusting license
- Cost containment
- Vendor coordination
Picked out of the job description automatically; check the full description for what the employer asks for.
About the job
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 Examiner, Auto | Bodily Injury
PRIMARY PURPOSE OF THE ROLE: To analyze complex or technically difficult auto and general liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.
ESSENTIAL RESPONSIBLITIES MAY INCLUDE
- Analyzes and processes complex or technically difficult general liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
- Assesses liability and resolves claims within evaluation.
- Negotiates settlement of claims within designated authority.
- Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
- Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
- Prepares necessary state fillings within statutory limits.
- Manages the litigation process; ensures timely and cost effective claims resolution.
- Coordinates vendor referrals for additional investigation and/or litigation management.
- Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
- Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
- Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
- Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
- Ensures claim files are properly documented and claims coding is correct.
- Refers cases as appropriate to supervisor and management.
- Performs other duties as assigned.
- Supports the organization's quality program(s).
QUALIFICATIONS Education & Licensing: Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage’s, principles, and laws.
- Bachelor's degree from an accredited college or university preferred.
- Professional certification as applicable to line of business preferred.
- Skills: strong oral and written communication, including presentation skills, PC literate including Microsoft Office products, and ability to work in a team environment.
- Secure and maintain the State adjusting licenses as required for the position.
Work environment requirements include – Physical: Computer keyboarding Auditory/visual: Hearing, vision and talking Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
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. at any time.
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.
From Sedgwick Claims Management Services Inc.'s careers page (Workday), checked 3 Nov 2026.
How to apply
- Select Apply on sedgwick.wd1.myworkdayjobs.com. It opens Sedgwick Claims Management Services Inc.'s own application form in a new tab, run on Workday.
- Fill in the form and upload your résumé there. Jobiwork never sees your application.
- Sedgwick Claims Management Services Inc. will reply to you directly. No real employer asks you for money to apply.
Posted 2 Nov 2026 · checked 3 Nov 2026 · Report this job