Sedgwick
Complex Claims Advisor | Commercial GL and Auto | Remote
Sedgwick, Boston, Massachusetts, us, 02298
Overview
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 Workplace National Top Companies
Certified as a Great Place to Work®
Fortune Best Workplaces in Financial Services & Insurance
Position Title Complex Claims Advisor | Commercial GL and Auto | Remote
Why Join Us
Enjoy flexibility and autonomy in your daily work, your location, and your career path.
Be 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? Are you an experienced attorney or examiner with a strong background in insurance coverage analysis? We’re seeking an experienced attorney or senior level examiner with a strong background in insurance coverage analysis to support insurance carriers by evaluating claims and loss complaints, interpreting policy language, and drafting Reservation of Rights and disclaimer letters. This role offers the opportunity to apply your expertise in commercial general liability and auto policies, endorsements, exclusions, and litigation support, while delivering clear, actionable coverage opinions and collaborating with claims professionals and managers. If you thrive in a detail‑oriented, analytical environment and have a passion for coverage law, we’d love to hear from you. Experience in claims handling or underwriting is a strong plus.
Primary Purpose To develop targeted solutions and provide added technical guidance and oversight. To evaluate insurance claims and loss complaints for coverage applicability, draft Reservation of Rights and disclaimer letters, and provide expert coverage opinions to insurance carriers. This role supports litigation and policy interpretation ensuring accurate and timely guidance on complex coverage issues.
Essential Functions and Responsibilities
Proactively and strategically manage a complex claim inventory by assessing complex claims issues, utilizing jurisdictional expertise to provide oversight, and directing the handling to achieve the best possible resolution.
Act as the organizational subject matter expert for line of business and key jurisdictions on complex claim issues.
Use knowledge of all aspects of claims handling in evaluating exposure; recommend and direct action plans for issue or case resolution.
Articulate and document clear and concise file notes to allow stakeholders to understand the issues and path to resolution.
Communicate complex coverage analyses to clients, claim examiners, and managers, translating technical policy language into actionable insights.
Demonstrate exceptional written communication skills and expertise in drafting clear, accurate coverage disclaimer letters and Reservation of Rights letters.
Facilitate roundtables with groups/teams and engage appropriate internal and external resources as needed.
Provide technical leadership on and maintain co‑ownership of complex claim issues; through further influence create a culture of continual quality improvement.
Additional Functions and Responsibilities
Perform other duties as assigned.
Support the organization’s quality program(s).
Travel as required.
Qualifications Education & Licensing Bachelor’s degree from an accredited college or university preferred. Industry designation(s) preferred. Licenses as required for specific jurisdictions.
Experience Eight (8) years of casualty claims experience or equivalent combination of education and experience required to include three (3) to five (5) years of experience handling complex claims and experience in negotiation, mediation, arbitration or ADR skills on higher value complex claims. Supervisory experience a plus. Specific jurisdictional expertise preferred.
Skills & Knowledge
Subject matter expertise in worker’s compensation claims and/or liability claims processing.
Ability to obtain and maintain appropriate licensing.
Ability to manage claims across multiple jurisdictions.
Excellent oral and written communication, including presentation skills.
PC literate, including Microsoft Office products.
Excellent analytical and interpretive skills.
Strong organizational 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.
Compensation and Benefits For this role the starting salary range is $100,000 – $110,000 USD annually. A comprehensive benefits package is offered, including medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
Equal Opportunity Statement Sedgwick is an Equal Opportunity Employer and a Drug‑Free Workplace.
Additional Information 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.
Contact For more information, visit sedgwick.com.
#J-18808-Ljbffr
Newsweek Recognizes Sedgwick as America’s Greatest Workplace National Top Companies
Certified as a Great Place to Work®
Fortune Best Workplaces in Financial Services & Insurance
Position Title Complex Claims Advisor | Commercial GL and Auto | Remote
Why Join Us
Enjoy flexibility and autonomy in your daily work, your location, and your career path.
Be 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? Are you an experienced attorney or examiner with a strong background in insurance coverage analysis? We’re seeking an experienced attorney or senior level examiner with a strong background in insurance coverage analysis to support insurance carriers by evaluating claims and loss complaints, interpreting policy language, and drafting Reservation of Rights and disclaimer letters. This role offers the opportunity to apply your expertise in commercial general liability and auto policies, endorsements, exclusions, and litigation support, while delivering clear, actionable coverage opinions and collaborating with claims professionals and managers. If you thrive in a detail‑oriented, analytical environment and have a passion for coverage law, we’d love to hear from you. Experience in claims handling or underwriting is a strong plus.
Primary Purpose To develop targeted solutions and provide added technical guidance and oversight. To evaluate insurance claims and loss complaints for coverage applicability, draft Reservation of Rights and disclaimer letters, and provide expert coverage opinions to insurance carriers. This role supports litigation and policy interpretation ensuring accurate and timely guidance on complex coverage issues.
Essential Functions and Responsibilities
Proactively and strategically manage a complex claim inventory by assessing complex claims issues, utilizing jurisdictional expertise to provide oversight, and directing the handling to achieve the best possible resolution.
Act as the organizational subject matter expert for line of business and key jurisdictions on complex claim issues.
Use knowledge of all aspects of claims handling in evaluating exposure; recommend and direct action plans for issue or case resolution.
Articulate and document clear and concise file notes to allow stakeholders to understand the issues and path to resolution.
Communicate complex coverage analyses to clients, claim examiners, and managers, translating technical policy language into actionable insights.
Demonstrate exceptional written communication skills and expertise in drafting clear, accurate coverage disclaimer letters and Reservation of Rights letters.
Facilitate roundtables with groups/teams and engage appropriate internal and external resources as needed.
Provide technical leadership on and maintain co‑ownership of complex claim issues; through further influence create a culture of continual quality improvement.
Additional Functions and Responsibilities
Perform other duties as assigned.
Support the organization’s quality program(s).
Travel as required.
Qualifications Education & Licensing Bachelor’s degree from an accredited college or university preferred. Industry designation(s) preferred. Licenses as required for specific jurisdictions.
Experience Eight (8) years of casualty claims experience or equivalent combination of education and experience required to include three (3) to five (5) years of experience handling complex claims and experience in negotiation, mediation, arbitration or ADR skills on higher value complex claims. Supervisory experience a plus. Specific jurisdictional expertise preferred.
Skills & Knowledge
Subject matter expertise in worker’s compensation claims and/or liability claims processing.
Ability to obtain and maintain appropriate licensing.
Ability to manage claims across multiple jurisdictions.
Excellent oral and written communication, including presentation skills.
PC literate, including Microsoft Office products.
Excellent analytical and interpretive skills.
Strong organizational 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.
Compensation and Benefits For this role the starting salary range is $100,000 – $110,000 USD annually. A comprehensive benefits package is offered, including medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
Equal Opportunity Statement Sedgwick is an Equal Opportunity Employer and a Drug‑Free Workplace.
Additional Information 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.
Contact For more information, visit sedgwick.com.
#J-18808-Ljbffr