意外理赔调整员 - RGA
Casualty Desk Adjuster - RGA
加入Sedgwick,你将参与真正有意义的事业。我们的33,000名同事每天为全球面临意外的人们提供帮助。我们邀请你与我们共同成长,体验我们的关怀文化,并享受工作与生活的平衡。在这里,你的成就没有上限。
Newsweek 将 Sedgwick 评为美国最佳工作场所全国顶级公司
被认证为最佳工作场所®
财富最佳金融服务与保险工作场所
伤亡理赔专员 - RGA
主要职责:候选人应至少有5年(最好是10年以上)公共实体和EPL(雇佣行为责任)和/或CSA(儿童性侵)索赔处理经验。处理复杂、技术性强的索赔。在涉及责任、损害、证据或其他复杂法律问题的索赔中进行理赔,同时提供卓越的客户体验。
核心职责和责任
- 根据损害、保险合同、公司政策和适用的州法律,评估和确定风险敞口和伤害索赔。
- 调查并评估在处理涉及严重和灾难性伤害、责任和其它法律问题的索赔中的责任和损害。
- 确保及时将诉讼转交律师,并在发现过程中评估风险变化,考虑成本和行动策略以准备审判或确定和解能力。
- 负责管理在处理严重和复杂索赔、诉讼索赔以及复杂责任情况中的辩护律师;管理在处理严重和复杂索赔中的辩护律师。
- 制定有效的计划,推动索赔解决,同时关注赔偿和费用泄漏。
- 评估责任并起草包含保留权利和责任拒绝的理赔信。
- 对所有待处理的索赔保持适当的准备金。
附加职责和责任
- 执行其他指派的任务。
- 按需出差
资格要求
教育与执照
优先考虑来自认可大学或学院的学士学位。根据州规定需要理赔员执照。优先考虑保险认证如CPCU、AIC、ARM。
经验
8年相关经验,包括个人理赔经验、评估责任和起草包含保留权利和责任拒绝的理赔信的经验。
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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
Casualty Desk Adjuster - RGA
PRIMARY PURPOSE: Candidate should have at least 5 years (prefer 10+) of Public Entity and EPL(Employment Practices Liability) and/or CSA (Childhood Sexual Assault) claims handling experience. Handles complex, technically challenging claims.. Adjusts claims with complex coverage issues involving liability, damages, evidence, or other complex legal issues, while providing an exceptional customer experience.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
- Develops exposures and evaluates injury claims based on damages, the insurance contract, company policies, and applicable state laws.
- Investigates and evaluates coverage, liability and damages in handling of claims involving serious and catastrophic injuries, coverage, and other legal issues.
- Ensures timely referral of suits to counsel and evaluates changes in exposure through the course of discovery, considering costs and strategic plan of actions to prepare for trial or determine settlement capability.
- Responsible for managing defense counsel in litigation of serious and complex claim, litigated claims as well as complex coverage scenarios; manages defense counsel in litigation of serious and complex claims.
- Formulates effective plans to bring the claims to resolution while focusing on indemnity and expense leakage.
- Evaluates coverage and drafts coverage letters to include both reservation of rights and coverage denials.
- Maintains proper reserves on all pending claims.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
- Performs other duties as assigned.
- Travel as required
QUALIFICATIONS
Education & Licensing
Bachelor's degree from an accredited college or university preferred. State mandated adjusting licenses as required. Insurance designations such as CPCU, AIC, ARM preferred.
Experience
Eight (8) years of related experience to include experience in personal lines claims, evaluating coverage and drafting coverage letters to include both reservation of rights and coverage denials, or equivalent combination of education and experience required. Experience with commercial lines claims and litigation in multiple states preferred.
Skills & Knowledge
- Exposure to and knowledge of affluent market segment
- Strong knowledge of tort theories, legal concepts, negotiation strategies, and litigation management
- Excellent oral and written communication skills, including presentation skills
- PC literate, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skills
- Excellent interpersonal skills
- Excellent negotiating skills
- Ability to create and complete comprehensive, accurate and constructive written reports
- Ability to work in a team environment
- Ability to meet or exceed Performance Competencies
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 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.
As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. 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. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ($100,000 - $120,000 USD annually). 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
Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.
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.
Originally posted on Himalayas