
Job Overview
Location
Telecommuter FL
Job Type
Full-time
Category
Customer Service
Date Posted
June 14, 2026
Full Job Description
📋 Description
- • Handles property and casualty insurance claims valued up to $15,000 by thoroughly reviewing insurance policies, claims forms, endorsements, and carrier instructions to determine coverage eligibility.
- • Conducts investigations by gathering 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 collect accurate information regarding claim details and circumstances.
- • Estimates the cost of repair, replacement, or compensation based on documented evidence and industry standards.
- • Prepares detailed reports of findings and negotiates claim settlements in strict adherence to carrier-specific instructions and guidelines.
- • Issues settlement checks, files required regulatory documentation, and manages salvage and subrogation processes where applicable.
- • Recommends litigation to the legal department when a claim cannot be resolved through negotiation.
- • Attends litigation hearings and participates in depositions as required by case needs.
- • 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 and improve operational efficiency.
- • Escalates claims exceeding $15,000 gross loss amount to leadership for authorization and approval.
- • 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 coverage outcomes.
- • Produces comprehensive, 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 for claims handling accuracy, timeliness, and customer service.
- • Maintains proficiency in Microsoft Office products and other claim management systems.
- • Adapts to changing priorities, manages multiple claims simultaneously, and operates effectively under work-related stress.
- • Performs computer keyboarding tasks and travels as required for inspections or hearings.
- • Maintains clear hearing, vision, and verbal communication abilities to effectively conduct interviews and hearings.
Skills & Technologies
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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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