Medical Insurance Claims Processor Jobs in Houston, TX

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.

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Claims Representative, Auto | Property Damage

PRIMARY PURPOSE OF THE ROLE: To analyze and process low to mid-level auto and transportation claims.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Processes auto property damage and lower level injury claims; assesses damage, makes payments, and ensures claim files are properly documented and correctly coded based on the policy.

• Develops and maintains action plans to ensure state required contract deadlines are met and to move the file towards prompt and appropriate resolution.

• Identifies and pursues subrogation opportunities; secures and disposes of salvage.

• Communicates claim action/processing with insured, client, and agent or broker when appropriate.

• Maintains professional client relations.

• Performs coverage, liability, and damage analysis on all claims assignments.

• Performs other duties as assigned.

• Supports the organization's quality program(s).

QUALIFICATIONS

• Education: Bachelor's degree from an accredited college or university preferred. Secure and maintain the State adjusting licenses as required for the position.

• Familiarity with personal and commercial lines policies and endorsements

• Ability to review and assess Property Damage estimates, total loss evaluations, and related expenses to effectively negotiate first and third party claims.

• Knowledge of total loss processing, State salvage forms and title requirements, preferred

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Analytical and interpretive skills

• Strong organizational skills

• Good interpersonal skills

• Ability to work in a team environment

Work environment requirements include -

Physical: Computer keyboarding

Auditory/visual: Hearing, vision and talking

Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.

When applicable and appropriate, consideration will be given to reasonable accommodations.

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 $50,000 to $55,000 . 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.

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.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.

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