Description

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

Lawyer Auditor

PRIMARY PURPOSE: To address and handle high end cases with serious injuries, complex coverage scenarios and legal inquiries or disputes; to develop a strategy to bring a case to satisfactory resolution.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Reviews/acts on reports/forms; responds to inquiries; seeks legal opinion and early resolution; and communicates resolution to appropriate parties.
• Handles high end cases with serious injuries and/or complex coverage scenarios.
• Responds to decisions, agreement, and/or court order; creates action plan; determines need for examination; gains client authorization.
• Identifies cases for settlements/redemptions.
• Gathers/documents additional information and coordinates with client designees.
• Requests legal/private investigation; assigns to and coordinates with local counsel; monitors local counsel performance.
• Responds to plaintiff's counsel, union, employee, or client requests.
• Identifies issues and formulates defense strategy.
• Establishes/adjusts accrued liability and approves administrative expenses.
• Identifies subrogation opportunities and manages process.
• Attends and participates in mediations, trials, arbitrations or hearings as needed.
• Works with partners to affect early return-to-work.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.
• Supports the organization's quality program(s).

QUALIFICATIONS

Education & Licensing
Bachelor's degree from an accredited college or university preferred. Juris Doctorate (JD) preferred.

Experience
Ten (10) years of experience handling litigation including 5 years of claims management experience or equivalent combination of education and experience required.

Skills & Knowledge

• Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
• Technically skilled and familiar with legal pleadings, discovery et al
• Excellent oral and written communication, including presentation skills
• PC literate, including Microsoft Office products
• Analytical and interpretive skills
• Strong organizational skills
• Excellent interpersonal skills
• Excellent negotiation skills
• Ability to work in a team environment
• Ability to meet or exceed Performance Competencies

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.

Sedgwick is an Equal Opportunity Employer.

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. Sedgwick retains the discretion to add or to change the duties of the position at any time.