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Claims examiner • providence ri

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Claims Examiner | General Liability BI | Captive | Remote

Claims Examiner | General Liability BI | Captive | Remote

SedgwickProvidence, RI, US
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Claims Examiner | General Liability BI | Captive | Remote.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 ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Remote Claims Writer

Remote Claims Writer

Metro Public AdjustmentPawtucket, RI, US
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Job Description : The position we are hiring for is customer / client relations.In this position you will be writing claims and submitting the paperwork. Duties can be performed remotely.Company Inform...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Claims Adjuster (35406)

Claims Adjuster (35406)

Neighborhood Health Plan of Rhode IslandSmithfield, RI, US
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Responsibilities include, but are not limited to,.Researches and interprets submitted requests to determine claim accuracy and the need for claim adjustment. Responds to inquiry with clear explanati...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Senior Environmental Claims Adjuster (CONTRACT)

Senior Environmental Claims Adjuster (CONTRACT)

Argonaut Management Services, IncProvidence, RI, United States
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Argo Group International Holdings, Inc.American National, US based specialty P&C companies, (together known as BP&C, Inc. Brookfield Wealth Solutions, Ltd.BWS"), a New York and Toronto-listed public...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
RI SAFE Examiner

RI SAFE Examiner

LifeSpanProvidence, Rhode Island, United States
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SAFEs will be mission driven with a commitment to participating in SAFE on call and emergency response care at all Lifespan Emergency Departments. SAFEs will collaborate with medical providers in th...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Insurance Claims Environmental

Insurance Claims Environmental

Diedre Moire Corp.South Attleboro, MA, US
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Counsel Asbestos Litigation - Attleboro, MA Insurance Claims Specialist Adjuster Examiner Analyst Attorney Environmental Toxic Tort Asbestos Pollution Health Hazard _. REMOTE WORK FROM HOME AVAILABL...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
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Commercial Field Examiner - Commercial Lending Auditor

Commercial Field Examiner - Commercial Lending Auditor

M&T BankLincoln, RI, US
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Performs more complex field examinations of clients and prospective clients to provide the Bank with a first level of risk management by determining collateral adequacy, identifying operational iss...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Field Claims Adjuster

Field Claims Adjuster

EAC Claims Solutions LLCProvidence, Rhode Island, United States
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At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency.Join us in delivering exceptional service while upholding the highest standards of professionalism and co...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Customer Claims Processing Representative

Customer Claims Processing Representative

Pet Food Experts IncPawtucket, RI, US
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Join the Pack at Pet Food Experts!.With a rich history spanning over 80 years, Pet Food Experts has evolved from a small family-run business into the nation's leading pet specialty distributor,...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Claims Examiner - Workers Compensation REMOTE | California Experience

Claims Examiner - Workers Compensation REMOTE | California Experience

Rhode Island StaffingProvidence, RI, US
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Claims Examiner - Workers Compensation.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 ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Commercial Title Examiner

Commercial Title Examiner

StewartProvidence, RI, US
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Provides nationwide title services.Responsible for supporting real estate transactions by searching public records and examining titles for properties to determine legal condition of property title...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
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Senior Claims Consultant

Senior Claims Consultant

PremierProvidence, RI, US
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This position will be responsible for managing all aspects of catastrophic medical professional liability claims for designated clients / insureds. Management of claims includes but is not limited to : ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Personal Injury Plaintiff Claims Adjuster

Personal Injury Plaintiff Claims Adjuster

Providence Staffing LLCProvidence, RI, US
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Providence Staffing's client, a respected personal injury law firm in Providence, RI, is seeking a detail-oriented and experienced. Personal Injury Plaintiff Claims Adjuster.This role is critica...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Claims Auto Adjuster

Claims Auto Adjuster

AAAProvidence, RI, US
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This entry-level position supports the Auto Claims Operation by providing service pursuant to the policy by handling claims of material damage, property damage, and / or liability lines of insurance ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Transaction Advisory Staff - Field Examiner

Transaction Advisory Staff - Field Examiner

Citrin CoopermanProvidence, RI, US
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Citrin Cooperman offers a dynamic work environment, fostering professional growth and collaboration.We’re continuously seeking talented individuals who bring fresh perspectives, a problem-solving m...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Sr. Construction Defect Claims Representative

Sr. Construction Defect Claims Representative

Frank Winston Crum InsuranceProvidence, RI, US
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Construction Defect Claims Representative.Frank Winston Crum Insurance (FWCI) issues Workers' Compensation and General Liability policies by offering flexible coverage and payment options to meet t...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Ohio Commercial Title Examiner (Remote)

Ohio Commercial Title Examiner (Remote)

First AmericanUSA, Rhode Island, Remote
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Join a team that puts its People First! First American's National Production Services division provides global title and escrow production support across all channels within First American Title in...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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(Remote) Claims Examiner - Workers Compensation | California Experience

(Remote) Claims Examiner - Workers Compensation | California Experience

Remote StaffingProvidence, RI, US
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Claims Examiner - Workers Compensation | California.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 ar...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
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Claims Auditor, Home Warranty

Claims Auditor, Home Warranty

AssurantProvidence, RI, US
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The purpose of this job is to provide oversight of the claims' submittal process by correctly adjudicating claims to the Terms of Agreement with the service provider. The claims auditor aims to supp...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Claims Examiner | General Liability BI | Captive | Remote

Claims Examiner | General Liability BI | Captive | Remote

SedgwickProvidence, RI, US
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Claims Examiner | General Liability BI | Captive | Remote

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

As a Claims Examiner at Sedgwick, you'll have the opportunity to take on new challenges and help solve complex problems.

  • Enjoy flexibility and autonomy in your daily work and your career path. This is a remote, work-at-home, telecommuter position.
  • Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

Are you an ideal candidate? Do you have experience as a Bodily Injury General Liability Claims Examiner working within commercial (captive) insurance program(s)? Are you skilled in coverage determination, handling litigated claims, and interpreting endorsements, nature of loss, and excluded coverages? If so, and you're looking to join one of the premier teams in the industry, we're looking for someone with your level of expertise.

Primary Purpose : To analyze complex or technically difficult 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 Functions and Responsibilities :

  • 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 claims within designated authority level.
  • Prepares necessary state filings 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.
  • Additional Functions and Responsibilities :

  • Performs other duties as assigned.
  • Supports the organization's quality program(s).
  • Travels as required.
  • Qualification :

    Education & Licensing : Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.

    Experience : Five (5) years of claims management experience or equivalent combination of education and experience required.

    Skills & Knowledge :

  • Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures 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
  • Excellent negotiation 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

    The range of starting pay for this role is $85,000.00 - $100,000.00 annual salary. 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.

    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.

    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.