Sedgwick

Director

• The Business Transformation Director leads enterprise or business unit–wide transformation programs, shaping strategy and ensuring cross-functional alignment and execution.
• The Director owns transformation outcomes that materially impact growth, efficiency, and customer experience through AI-enabled operating models.

Director, Business Transformation

Claims Specialist

• To analyze and provide resolution of complex General, Excess and Products Liability claims.
• Analyzes and processes complex or technically difficult general, excess and product liability claims.
• Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions.
• Negotiates claim settlement.
• Calculates, assigns, and monitors claims reserves.
• Recommends settlement strategies.
• Coordinates legal defense, monitors counsel for compliance with client guidelines.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients.
• Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost.
• Represents Company in depositions, mediations, and trial monitoring as needed.
• Maintains professional client relationships.

Claims Specialist, General Liability, Product Liability

Manager

• To manage the technical and operational functions within assigned Professional Liability offices with up to 10 full-time colleagues
• Establishes policy and procedures to assure compliance to best practices, claims management services standards, state regulations, and client service requirements
• Establishes business plan with goals and objectives for the partnership and locations/offices
• Monitors management reports relating to the partnership/office performance
• Assists with the coordination of sales and client service efforts

Professional Liability Claims Manager

Auditor

• The Attorney Auditor reviews legal and non-legal invoices on behalf of our clients for services provided to insurance carriers, corporate legal departments and government entities.
• The auditor will apply client specified billing guidelines and/or Generally Accepted Principles and Standards (“GAPS”).

Attorney Auditor

AI Engineer

• Architect and deploy LLM-powered and agentic AI solutions that transform claims intake, policy interpretation, fraud detection, and resolution workflows.
• Design end-to-end retrieval-augmented generation (RAG) systems leveraging enterprise knowledge bases, policy documents, SOPs, and historical claims data.
• Build autonomous and semi-autonomous agents capable of reasoning, planning, and executing multi-step claims processes.
• Develop stateful workflow orchestration layers that manage context, memory, and task sequencing across interactions.
• Implement planning and reflection loops that decompose complex claims scenarios into structured subtasks.
• Enable dynamic tool use through function calling and secure API integrations with claims systems, CRM platforms, document repositories, and analytics tools.
• Develop document intelligence pipelines using LLMs for summarization, entity extraction, classification, validation, and timeline reconstruction.
• Design structured prompt frameworks that enforce deterministic outputs and domain-aware reasoning.
• Build multi-agent systems that coordinate document review, coverage analysis, compliance checks, and decision support.
• Implement human-in-the-loop checkpoints for escalation, review, and override of AI-driven decisions.
• Develop guardrails, output validation layers, and hallucination mitigation strategies.
• Enforce structured outputs using schemas, type validation, and deterministic post-processing logic.
• Optimize token consumption, inference latency, and cloud infrastructure costs.
• Deploy scalable AI microservices using containerization and cloud-native architectures.
• Implement monitoring for model drift, retrieval quality degradation, reasoning failures, and workflow breakdowns.
• Maintain detailed audit logs of model decisions, agent reasoning steps, and tool executions.
• Develop evaluation frameworks to test reasoning accuracy, workflow completion rates, and system reliability.
• Collaborate with data engineering to build embedding pipelines, feature stores, and vector indexing strategies.
• Ensure compliance with Responsible AI standards, data privacy regulations, and enterprise governance policies.
• Partner with claims operations leadership to embed AI capabilities directly into adjuster and supervisor workflows.
• Measure business impact through cycle-time reduction, automation coverage, fraud detection lift, and operational efficiency gains.

Applied AI Engineer

Content Marketing Manager

• Investigate and adjust property and casualty claims, both residential and commercial, with little to no supervision.
• Inspects claims and contacts involved parties in a timely manner.
• Investigates circumstances of claim(s) as required for coverage determination, cause, and compensable damages/reserves.
• Examines insurance policies and other records to determine insurance coverage.
• Prepares estimates for cost of repair and/or replacement.
• Conducts interviews with claimant and witnesses regarding submitted claim(s).
• Negotiates and settles both 1st and 3rd party claims.
• Addresses salvage and subrogation as required by the client.
• Maintains client relationships to assure repeated business referrals.

Contents Adjuster

• Sets up and enters new claims into claims management system.
• Inputs and reviews notes/diaries in claims management system as instructed.
• Processes payments.
• Processes mail; handles filing, faxing and photocopying.
• Reviews, prepares, creates, and/or sends letters, reports, and forms.
• Answers and initiates telephone calls, sets up medical appointments, and may provide customer service as required.
• Other activities/projects as assigned including the preparation and distribution of computer reports

Claims Associate – Workers Compensation

• To maintain and ensure profitable growth, increasing market presence, and the development, retention, and value of existing client accounts.
• Develops and implements annual business plans, operating budget and revenues budget utilizing (EFI) business processes.
• Generates and establishes talent, management, and financial control plans to secure successful execution of territory performance.
• Oversees activities to ensure efficient operation of branch.
• Serves as a point of contact for communication between internal and external customers.
• Creates an environment of customer / colleague satisfaction.

Branch Manager

• Processes uncomplicated personal and commercial line property auto claims and ensures claim files are properly documented and coded correctly based on the policy.
• Maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution; escalates issues as needed.
• Identifies and pursues subrogation opportunities; secures and disposes of salvage.
• Communicates claim action/processing with insured, client and agent or broker when appropriate.
• Performs coverage, liability, and damage analysis on all claims assignments.

Auto Claims Associate

Analyst

• To coordinate new and/or renewal business pricing process and identify program trends impacting pricing
• To provide support to operational directors, program and office managers in development of program pricing and design
• To provide support for program implementations and department initiatives
• To review contracts and provide billing instructions to billing group
• Designs and prices new clients and prospective new business/rounding opportunities as assigned
• Assists in the design and pricing of client renewals; supports operations in renewal development
• Works closely with other departments as appropriate; communicates often with program managers, operations manager, managing departments and legal department
• Assists program implementations
• Generates ad hoc reporting and analysis as requested by management
• Compiles and analyzes financial data and makes recommendations for improved data capturing and analytics
• Assists in evaluation, development and enhancement of various pricing models
• Provides superior customer service and support to business/management strategies

Program Design Analyst

• To analyze complex or technically difficult general liability claims to determine benefits due;
• To work with high exposure claims involving litigation and rehabilitation;
• To ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements;
• To identify subrogation of claims and negotiate settlements.

General Liability Claims Examiner

• Analyzes and processes complex or technically difficult general liability claims by investigating and gathering information to determine the exposure on the claim;
• manages claims through well-developed action plans to an appropriate and timely resolution.
• Assesses liability and resolves claims within evaluation.
• Negotiates settlement of claims within designated authority.
• Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
• Prepares necessary state fillings within statutory limits.
• Manages the litigation process; ensures timely and cost-effective claims resolution.

Liability Claims Examiner – General Liability, Premise Liability, Litigation Experience

Attorney

• To analyze mid- and higher-level general liability claims to determine benefits due;
• to ensure ongoing adjudication of claims within company standards and industry best practices;
• to identify subrogation of claims and negotiate settlements.
• Manages mid-level general liability claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.
• Assesses liability and resolves claims within evaluation.

Claims Adjuster – Liability, Bodily Injury Experience with Attorney Representation

• To analyze reported lower-level general liability claims to determine benefits due.
• Ensures ongoing adjudication of claims within company standards and industry best practices.
• Handles lower-level liability and/or physical damage claims under close supervision.
• Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.

Claims Associate – Liability, NY & HI license Prop/Cas

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.