Job Overview

Location

Telecommuter FL

Job Type

Full-time

Category

Customer Service

Date Posted

June 25, 2026

Full Job Description

📋 Description

  • Handles property and casualty insurance claims valued up to $15,000 by examining insurance policies, claims forms, endorsements, and carrier instructions to determine coverage eligibility.
  • Conducts thorough investigations into claims by reviewing official reports, consulting police and hospital records, and inspecting physical damage or written repair estimates to assess the company’s liability.
  • Interviews, telephones, and corresponds with claimants and witnesses to gather detailed information regarding the nature and circumstances of each claim.
  • Estimates the cost of repair, replacement, or compensation based on inspection findings and documented evidence.
  • Prepares comprehensive reports of findings and negotiates claim settlements in strict adherence to carrier instructions and company guidelines.
  • Issues settlement checks, files required regulatory documentation, and manages salvage and subrogation processes where applicable.
  • Recommends litigation to the legal department when claims cannot be resolved through negotiation.
  • Attends litigation hearings and participates in depositions as required by case complexity or legal proceedings.
  • Regularly revises case reserves in assigned claims files to accurately reflect probable future costs and exposures.
  • Maintains an efficient and consistent caseload while meeting performance expectations and deadlines.
  • Utilizes technology and automation tools to streamline claim processing, improve accuracy, and enhance operational efficiency.
  • Escalates claims exceeding $15,000 gross loss amount to leadership for approval and authority review.
  • Performs additional duties as assigned to support team objectives and operational needs.
  • Demonstrates empathetic communication when interacting with claimants during stressful or emotional situations.
  • Applies strong analytical and interpretive skills to evaluate complex documentation and determine appropriate claim outcomes.
  • Produces clear, accurate, and constructive written reports that meet regulatory and internal standards.
  • Works collaboratively within a team environment while maintaining individual accountability for case outcomes.
  • Meets or exceeds established Performance Competencies related to claim handling, timeliness, and quality.
  • Maintains proficiency in Microsoft Office products and other claim management systems.
  • Possesses strong organizational, communication, and interpersonal skills to manage multiple priorities and deadlines effectively.
  • Adapts to work-related stress and demonstrates sound judgment in high-pressure claim resolution scenarios.
  • Performs computer keyboarding tasks and travels as required for inspections or hearings.
  • Maintains necessary auditory and visual capabilities to effectively communicate and review documentation.

Skills & Technologies

Onsite
Degree Required

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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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