Claims Examiner - Liability (REMOTE - License required)

Sedgwick Claims Management Services, Inc.

Job Overview

Location

26 Locations

Job Type

Full-time

Full Job Description

📋 Description

• As a Claims Examiner - Liability at Sedgwick, you will play a critical role in analyzing and resolving complex general liability claims, ensuring fair and timely outcomes for clients and claimants while upholding the company’s commitment to excellence in service and ethical claims handling.
• Your work directly supports Sedgwick’s mission to provide compassionate, expert claims management to individuals and organizations facing unexpected events, contributing to the company’s recognition as a Great Place to Work® and a leader in financial services and insurance workplace excellence.
• Day to day, you will analyze and process complex or technically difficult general liability claims by investigating incidents, gathering factual and documentary evidence, and determining exposure and liability based on policy terms and jurisdictional laws.
• You will assess liability and resolve claims within your evaluation authority, negotiating settlements with claimants, attorneys, and third parties to achieve fair and cost-effective resolutions within Sedgwick’s guidelines.
• You will calculate and assign appropriate reserves to claims, continuously monitoring and adjusting reserve adequacy throughout the claim lifecycle to ensure financial accuracy and compliance with actuarial and accounting standards.
• You will calculate and pay benefits due, approve and issue timely claim payments and adjustments, and ensure all financial transactions are processed accurately and in accordance with client-specific requirements and regulatory standards.
• You will tender claims to carriers and third parties when applicable, manage tender responses, and pursue subrogation opportunities to recover costs where liability lies with another party.
• You will read, analyze, and interpret insurance contracts, including indemnity and additional insured provisions, to determine coverage applicability and support accurate claim decisions.
• You will manage claims in a high-volume, fast-paced environment, balancing multiple priorities while maintaining strict adherence to service expectations, industry best practices, and client-specific requirements.
• You will support Sedgwick’s quality programs by participating in audits, peer reviews, and continuous improvement initiatives to ensure consistent, high-quality claims handling across the organization.
• You will travel as required to attend inspections, mediations, hearings, or meetings with clients, claimants, or legal representatives to gather information or support claim resolution.
• Sedgwick is a global leader in claims management with 33,000 colleagues worldwide, recognized by Newsweek as one of America’s Greatest Workplaces, certified as a Great Place to Work®, and honored by Fortune as a Best Workplace in Financial Services & Insurance, offering a culture rooted in empathy, accountability, collaboration, growth, and inclusion.
• The company operates across 26 locations and serves clients across virtually every industry, providing you with exposure to diverse claim types and the opportunity to work with some of the world’s most respected brands.
• In this role, you will develop deep expertise in general liability claims handling, including litigation-exposed cases, rehabilitation management, and complex coverage interpretation, positioning you for advancement within Sedgwick’s expansive career ladder.
• You will gain proficiency in reserve management, settlement negotiation, subrogation identification, and multi-jurisdictional claims processing—skills that are highly transferable and valuable across the insurance and risk management industries.
• Through Sedgwick’s professional development programs, mentorship opportunities, and access to a global network of experts, you will continuously build your knowledge and share insights while growing your career in a supportive, flexible, and autonomous work environment.

🎯 Requirements

• Active adjuster license required (state-specific licensure as applicable)
• Five (5) years of claims management experience or equivalent combination of education and experience
• Demonstrated success managing fast-track claims in a high-volume, fast-paced environment
• Proven experience handling General Liability products with strong understanding of coverage, exposure, and claims handling
• Strong competency in reading, analyzing, and interpreting contracts, including indemnity and additional insured provisions
• Experience tendering claims to carriers and third parties and managing tender responses

🏖️ Benefits

• Flexible work schedule
• Referral incentive program
• Career development and promotional growth opportunities
• A diverse and comprehensive benefits offering including medical, dental, vision, and 401(k) available on day one
• Access to professional development opportunities that support performance and career growth
• Enjoy flexibility and autonomy in your daily work, location, and career path

Skills & Technologies

Design

Remote

Degree Required

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Sedgwick Claims Management Services, Inc.

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About Sedgwick Claims Management Services, Inc.

Sedgwick is a global provider of technology-enabled risk, benefits and integrated business solutions, primarily handling insurance claims, managed care, absence and disability, and productivity management for employers, carriers, and administrators. The company processes millions of claims annually across workers' compensation, property, casualty, disability, and other lines, leveraging analytics and digital platforms to improve outcomes, reduce costs, and enhance customer and employee experiences.

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