Claims Examiner | Auto NF, PIP, MP | Remote

Sedgwick
Trenton, NJ
By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Examiner | Auto NF, PIP, MP | Remote Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?   + Enjoy flexibility and autonomy in your daily work, your location, and your career path. This role is open to a remote, telecommuter, work-at-home, or hybrid setting nationwide. + Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.  + Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.  **ARE YOU AN IDEAL CANDIDATE?** As a Claims Examiner, you will primarily handle auto-related liability claims for the following lines of coverage: Auto Liability, No Fault (NF), Personal Injury Protection (PIP), and Medical Payments (MP). No two days are the same as you assist our clients with their claims! If you are an agile auto claims examiner with 5+ years of experience, we want to talk to you! **PRIMARY PURPOSE OF THE ROLE** To analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly. + Responsible for litigation process on litigated claims. + Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims. + Reports large claims to excess carrier(s). + Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution. + Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage. + Communicates claim action/processing with insured, client, and agent or broker when appropriate. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required. **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Secure and maintain the State adjusting licenses as required for the position. **Experience** Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws. **Skills & Knowledge** + In-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws + Knowledge of medical terminology for claim evaluation and Medicare compliance + Knowledge of appropriate application for deductibles, sub-limits, SIR's, carrier and large deductible programs. + Strong oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Strong organizational skills + Strong interpersonal skills + Good negotiation skills + Ability to work in a team environment + Ability to meet or exceed Service Expectations **WORK ENVIRONMENT** When applicable and appropriate, consideration will be given to reasonable accommodations. **Mental:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines **Physical:** Computer keyboarding, travel as required **Auditory/Visual:** Hearing, vision and talking As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is _$78,951 - $87,428 USD annual salary._ A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. Always accepting applications. 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. at any time. \#remote #LI-REMOTE #claimsexaminer #autoclaims Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
Posted 2025-11-18

Recommended Jobs

Back End Java/Kafka Developer

Eliassen Group
Jersey City, NJ

Description: **Hybrid Onsite | 4 days per week in Jersey City, NJ** PROJECT OVERVIEW New squad focused on Fixed Income (bonds, trades) Working on a modernization project – development will be …

View Details
Posted 2025-11-01

RN

One Hamilton Health Place
Hamilton, NJ

Job Title: RN Location: RWJUH Hamilton Hospital Department Name: Operating Room Req #: 0000210114 Status: Hourly Shift: Day Pay Range: $45.55 - $58.06 per hour Pay Transparency: …

View Details
Posted 2025-10-28

Buyer

Amerlux
Oakland, NJ

Amerlux, a pioneer in the lighting industry for over 35 years, is seeking a Buyer  to join our Purchasing team in our Oakland, NJ office. This position is on-site five days per week. As a Buyer, you …

View Details
Posted 2025-10-31

Physician

Chenega Corporation
Fort Lee, NJ

**Summary** **CHENEGA TRI-SERVICES, LLC** Fort Lee, VA THIS IS AN INDEPENDENT CONTRACTOR 1099 POSITION The **Physician** shall perform medical histories, physical examinations, as well as review of re…

View Details
Posted 2025-11-15

Patient Transporter

One Robert Wood Johnson Place
New Brunswick, NJ

Job Title: Patient Transporter Location: Main Hospital - New Brunswick Department Name: Patient Transport Req #: 0000210702 Status: Hourly Shift: Evening Pay Range: $16.00 - $16.00 p…

View Details
Posted 2025-10-30

Technology Audit Manager - Commercial Investment Banking Technology

JPMorgan Chase & Co.
Jersey City, NJ

Job Description We are seeking an energetic team member to help  develop and execute annual audit plans, manage audit engagements, oversee and perform audit testing! As a Technology Audit Manage…

View Details
Posted 2025-11-17

Automotive Service Technician

Elkins Chevrolet LLC
Marlton, NJ

Elkins Chevrolet was founded as a single dealership in 1991 by Mike Elkins and takes a family business approach in the automotive industry. Elkins Chevrolet takes great pride in our long history of e…

View Details
Posted 2025-09-29

Chief Hospitalist - Regional Traveling

Hackensack, NJ

Physician - Hospitalist Job in Hackensack, NJ

View Details
Posted 2025-09-25

Lawn Sprinkler Irrigation Technician

Ecosystems - ProOutdoor - Quality Irrigation - Hydro Tech Irrigation
Dover, Morris County, NJ

Lawn Sprinkler Irrigation Technician Location: Dover, NJ (On-site) Schedule: Regular: Mon–Fri, 7 AM–5 PM Peak Season: Mon–Sat, 7 AM–7 PM Pay: $22–$35/hr + commission Hiring Bonus: $1…

View Details
Posted 2025-11-01