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Complex Claims Handling: Investigate, evaluate, negotiate, and settle highly complex property insurance claims, ensuring compliance with state regulations. Estimation Technology Proficiency: Utilize advanced estimation platforms to prepare detailed claims estimates for complex property insurance claims.
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Advises concerned parties of investigative findings (e.g., Law, Ethics, Human Resources, management for follow-up action/adjudication/documentation). Executes the preliminary investigative plan into complex investigations by using basic techniques by gathering data and employing subject matter experts to understand the facts and draw conclusions.
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PRIMARY PURPOSE : To supervise the operation of a teams of examiners and technical staff for liability auto claims for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims.
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Provides technical/jurisdictional direction to examiner reports on claims adjudication. Must have at a minimum 5 years handling bodily injury claims at the adjuster and/or team lead level. Auto Liability Claims Team Lead.
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Supervises a team of examiners that handle auto liability and bodily injury claims and/or several (minimum seven) technical operations colleagues for a wide span of control; may delegate some duties to others within the unit.
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The team will handle auto property damage and bodily injury claims. Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner. Acts as second level of appeal for client and claimant issues regarding claim specific, procedural or special requests; implements final disposition of the appeal.
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For the jurisdiction noted in this job posting only, the range of starting pay for this role is $92,000.00. NOTE : Credit security clearance, confirmed via a background credit check, is required for this position.
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Performs quality review on claims in compliance with audit requirements, service contract requirements, and quality standards. Provides support, guidance, leadership and motivation to promote maximum performance.
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Monitors third party claims; maintains periodical review of litigated claims, questionable claims and sensitive claims as determined by client. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
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PRIMARY PURPOSE : To supervise the operation of multiple teams of examiners and technical staff for liability claims for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims.
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And it means working in an environment that celebrates diversity and is fair and inclusive. Identifies and advises management of trends, problems, and issues as well as recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the office.
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Ensures claims files are coded correctly and adequate documentation is made by claims examiners. It's having support for your mental, physical, financial and professional needs. 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.
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Thorough knowledge of claims management processes and procedures for multiple product lines. Six (6) years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.
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When applicable and appropriate, consideration will be given to reasonable accommodations. It means having flexibility and time for all the things that are important to you. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
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Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. Administers company personnel policies in all areas and follows company staffing standards and training recommendations.
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adjudication complex jobs
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