Claims Resolution Senior I

Within SDG&E, championing our people is a key part of our values and our strategic mission. Thank you for continuing your journey with SDG&E! 

 

This position is open to SDG&E employees only.

 

Career Level: P3

 

Primary Purpose:
Investigates moderately complex claims, synthesizes evidence, and negotiates settlements within authority. Balances speed, accuracy, and recovery to optimize financial and customer outcomes.

 

Serves as a primary point of contact for emergency and after-hours claim call outs, timely response to incidents, reports of public safety concerns, incident coordination, and claims guidance to support operational, customer, and regulatory needs. Responsible for regulatory compliance through the assessment, coordination, and timely reporting of CPUC emergency electrical incidents and other reportable events. 

 

Duties and Responsibilities:

• Conducts and performs onsite, field, or internal investigations to determine the root causes, impacts, and effects of claims and incidents.
• Reviews internal and external records, files, and documents regarding incident investigations, liability and damage evaluation, and claims negotiation and settlements.
• Processes escalated claims, assesses the reason for the escalation, and provides resolution ensuring smooth operation.
• Evaluates and assesses potential risks associated with claims and provides recommendations to mitigate these risks.
• Identifies potential suspicious claims and opportunities for third-party subrogation.
• Negotiates settlements with claimants or their representatives while balancing the company's financial and reputational interests.
• Identifies opportunities to improve the claims handling process and contributes to the development and implementation of best practices.
• Frequent, independent driving to meetings, company locations, field locations and/or active incidents sites while maintaining a focus on safety and compliance with traffic laws is essential to this position and cannot reasonably be accomplished via alternative transportation.
• Performs other duties as assigned.

Required Qualifications:

• Typically requires a 4 year degree in a relevant field, or equivalent combination of relevant education and experience.
• Typically requires 5 years of related experience.

Required Licenses and Certifications:

• A valid California driver's license is required.

Required Knowledge, Skills and Abilities:

• Ability to evaluate complex claim facts using multiple sources of information.
• Ability to exercise independent judgment in ambiguous or non-standard situations.
• Ability to provide guidance to less experienced professionals without formal authority.
• In-depth knowledge of claims investigation methods, liability analysis, and settlement evaluation.
• Knowledge of related disciplines such as legal support, risk management, and insurance practices.
• Skill in identifying root causes, patterns, and risk implications within claims.
• Skill in influencing outcomes through professional negotiation and explanation.
• Requires availability for emergency and after-hours call-outs related to claims investigations, including matters involving public safety.

For internal employee applicants, selection into a position or a change in job grade or salary range does not automatically result in a change to an employee's compensation. Any compensation adjustment is made in accordance with Company compensation policies and practices and may consider a variety of factors, including the responsibilities of the position, internal equity, market considerations, qualifications, skills, experience, and overall business needs. Employees who voluntarily move to a position with a lower pay grade or salary range than their current position may be subject to a compensation adjustment, including a reduction in pay, consistent with Company guidelines and applicable law.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, citizenship, disability or protected veteran status.