Claims Adjuster, Liability

Sedgwick

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

Posted 10/9/2026full-timeRemote • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in analyzing general liability claims, ensuring compliance with industry standards, and effectively negotiating settlements. Proficient in managing claims processes, maintaining client relationships, and applying insurance principles and laws.

Highest-signal resume keywords

Claims Management ExperienceInsurance Principles ExpertiseNegotiation SkillsAnalytical SkillsMicrosoft Office Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

General Liability Claims AnalysisClaims AdjudicationSubrogation IdentificationClaims Payment ProcessingMedical Management PracticesClaims CodingCost Containment PrinciplesSocial Security Application ProceduresMedicare Application ProceduresReserve Value Assignment

Soft Skills

Excellent Oral CommunicationExcellent Written CommunicationStrong Organizational SkillsGood Interpersonal SkillsAbility to Work in a Team Environment

Industry Keywords

Claims ProcessingLiability Exposure AssessmentQuality ProgramsService ExpectationsWork-Related Stress Management

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 opportunities and negotiate settlements
Gather information to determine liability exposure
Assign reserve values and make claims payments as necessary
Settle claims up to the designated authority level
Assess liability and resolve claims within evaluation
Approve and process assigned claims and determine benefits due
Manage action plans pursuant to the claim or client contract
Communicate claim action 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 when applicable
Maintain professional client relationships
Support the organization's quality programs
Perform other duties as assigned

Requirements

What you’ll need

Bachelor's degree from an accredited college or university preferred
Four (4) years of claims management experience or equivalent combination of education and experience required
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, and cost containment principles
Knowledge of medical management practices and Social Security and Medicare application procedures as applicable
Excellent oral and written communication, including presentation skills
PC literacy, 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 handle work-related stress and multiple priorities simultaneously
Ability to meet deadlines
Ability to travel as required

Benefits

Comp & perks

Work-life balance
Equal Opportunity Employer
Drug-Free Workplace
Reasonable accommodations when applicable and appropriate
Consideration as a candidate for other roles if experience does not align perfectly