4 claims adjudicator jobs found in Jacksonville, FL

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 Adjuster - Liability (REMOTE - Prefer to be in Jacksonville, FL; BI/Lit Experience) 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?   Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.  Deliver innovative customer-facing solutions to clients who represent virtually every industry and...

Responsible for providing professional customer service to insureds and accounts while adjudicating credit protection and debt cancellation claims. Allocates time between claim adjudication and claims customer service, reviewing submitted information, coverage, and documentation in a timely manner. Minimum Qualifications: High School Diploma or equivalent. 2 years’ experience in claims and/or other related claims processes. Customer Service training is imperative since we communicate verbally on the phone and in written correspondence. Fraud Awareness training and Claims Experience required.   Insurance Certifications, designations or licenses preferred, not required. Primary Job Functions: Enter and adjudicate claims by reviewing documentation and determining appropriate action (pay, pend, or deny) in accordance with policy provisions, exclusions, and eligibility criteria. Dynamically allocating time between claim adjudication and inbound...

Primarily responsible for providing exceptional customer service to our clients. Take incoming calls using our Web Warranty/Web Claim program. Review claims for approvals, distribution of authorizations or sending of denial letters. Helps to enforce contractual requirements impartially and expeditiously. Adjudicate, investigate and/or deny claims by verifying submitted information, coverage issued, and other pertinent information. Identify claims of a potentially fraudulent nature and refer to management for review. Monitor and process claims to meet the demands of a production environment and to adhere to established service standards. Process claims via our phone and portal systems using Web Warranty/Web Claims program Handle customer service questions or transfer call to appropriate numbers Adjudicate claims based off the terms and conditions of the service contract Follow-up with Service Providers and Technicians for required claims information Complete Claim...

Company Details   Carolina Casualty  is a member company of  W. R. Berkley Corporation , an insurance holding company that is among the largest commercial lines insurance writers in the United States. We specialize in liability, physical damage, cargo and other insurance solutions for the commercial auto markets including trucking, public transportation and others.    The company is an equal employment opportunity employer. Responsibilities The primary role of a Complex Claims Specialist is to promptly and professionally ensure high quality claim handling by analyzing liability of claim submissions while making coverage determinations, investigating losses, conducting independent assessment as to the insured’s exposure and moving cases towards timely resolution. You will be an effective source for help and support because of your deep knowledge and liability claim expertise. Key Functions   will...