Claims Adjuster, Auto – Liability

Sedgwick

. Analyze mid- and higher-level general liability claims to determine benefits due .

Posted 10/26/2026full-timeRemote • Texas • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in claims management, including analyzing general liability claims, negotiating settlements, and ensuring compliance with insurance principles and laws. Proficient in maintaining client relationships and managing complex medical claims while adhering to industry best practices.

Highest-signal resume keywords

Claims Management ExperienceNegotiation SkillsInsurance Principles ExpertiseAnalytical SkillsCommunication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AnalysisSubrogation ManagementClaims CodingMedical Management PracticesCost Containment PrinciplesMicrosoft Office ProficiencyPresentation SkillsLiability AssessmentSettlement NegotiationAction Plan Management

Soft Skills

Organizational SkillsInterpersonal SkillsTeam CollaborationJudgment and DiscretionDeadline Management

Industry Keywords

General Liability ClaimsSocial Security Application ProceduresMedicare Application ProceduresRecovery OffsetsDisability Duration

About the role

Key responsibilities & impact

Analyze mid- and higher-level general liability claims to determine benefits due
Ensure ongoing adjudication of claims within company standards and industry best practices
Identify subrogation of claims and negotiate settlements
Manage mid-level general liability claims by gathering information to determine liability exposure
Assign reserve values to claims, make claims payments as necessary, and settle claims up to designated authority level
Assess liability and resolve claims within evaluation
Approve and process assigned claims, determine benefits due, and manage action plans pursuant to the claim or client contract
Manage subrogation of claims and negotiate settlements
Communicate claim actions with claimants and clients
Ensure claim files are properly documented and claims coding is correct
Process complex lifetime medical and/or defined period medical claims, including state and physician filings and treatment decisions recommended by utilization review
Maintain professional client relationships
Support the organization's quality programs
Perform other duties as assigned

Requirements

What you’ll need

Four (4) years of claims management experience or equivalent combination of education and experience required
Bachelor's degree from an accredited college or university preferred
Subject matter expertise in appropriate insurance principles and laws for the applicable line of business
Knowledge of recoveries, offsets and deductions, claim and disability duration, cost containment principles, medical management practices, and Social Security and Medicare application procedures as applicable
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Good interpersonal skills
Excellent negotiation skills
Ability to work in a team environment
Ability to meet or exceed Service Expectations
Ability to perform computer keyboarding
Hearing, vision and talking abilities
Clear and conceptual thinking ability; excellent judgment and discretion
Ability to meet deadlines

Benefits

Comp & perks

Work-life balance
Equal Opportunity Employer
Drug-Free Workplace
Diverse, equitable, and inclusive workplace