PRIMARY PURPOSE A claims adjuster is charged with the investigation, evaluation and quantification of an insurance claim.  The adjuster will determine and provide recommendations with respect to coverage, liability and quantum, within the terms of the policy.    

ESSENTIAL FUNCTIONS and RESPONSIBILITIES 

• Manages/adjusts assigned claims while meeting company standards and quality, including conducting thorough investigations; determining coverage and validity of claims, interviewing and communicating with insured, claimants and witnesses; inspecting claims sites as required, assigning external vendors as required, recommendations for reserves, preparing reports and negotiating settlements within granted authority.  Participate in mediation and arbitrations as required.  Work with defense counsel as assigned.   

• Maintains accurate records based on company standards and procedures, using company custom computer systems.  Will require the ability to work in external client systems.  

• Accurately and efficiently manages the billing for assigned files, within specified timelines 

• Assists with collection of accounts receivables for assigned claims 

• Assists with local marketing of the branch; attends professional and social events and develops new business opportunities.  

• Maintains an excellent working relationship with existing clients to further develop business and will participate as required in client file reviews and audits.   

• Requires a high level of mathematical and reasoning ability to calculate and analyze data to arrive at a logical conclusion 

• The ability to cope with extreme weather, environmental and driving conditions at any time of day or night. 

• Committed to continuous education to keep up-to-date with all industry and legislative issues and changes and licensing requirements.  

• Responsible to ensure reserves, coding and reporting is up to date on claims files assigned.   

• Assists with local marketing of the branch; attends professional and social events and develops new business opportunities.  

ADDITIONAL FUNCTIONS and RESPONSIBILITIES 

• Performs other duties as assigned. 

• Supports the organization's quality program(s). 

QUALIFICATIONS 

Education & Licensing 

• Post-secondary education 

• Has or is working toward CIP designation 

• Must be licensed or have the ability to obtain a provisional license 

• Must possess a valid driver's license 

• Proven adjusting and negotiating skills 

• Excellent interpersonal and communication skills, and computer proficiency 

Experience 

• Proven adjusting and negotiating skills 

• Excellent interpersonal and communication skills, and computer proficiency 

Skills & Knowledge 

• Strong knowledge of insurance, claims or business management 

• Excellent oral and written communication 

• PC literate, including Microsoft Office products and Excel 

• Ability to navigate and work in client required ancillary systems  

• Ability to work in a remote/home office environment   

• Analytical and interpretive skills 

• Strong organizational skills 

• Excellent interpersonal skills 

• Excellent negotiation skills 

• Ability to work in a team environment 

• Ability to meet or exceed Performance Competencies 

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. 

We are committed to inclusive, barrier-free recruitment and selection processes. If contacted for an employment opportunity, please advise Colleague Resources if you require accommodation. 

Sedgwick is an Equal Opportunity Employer