Sedgwick

Claims Specialist

• Analyze complex or technically difficult workers' compensation claims to determine benefits due
• Work with high exposure claims involving litigation and rehabilitation
• Ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements
• Identify subrogation of claims and negotiate settlements
• Communicate claim activity and processing with the claimant and the client; maintains professional client relationships

Claims Examiner – Workers Comp

Administrative Assistant

• Provide administrative support including preparing correspondence and reports, filing, and other general office support activities.
• Produces correspondence, reports, and other documentation; files documents, maintains and tracks suspense file, photocopies, etc.
• Provides back-up telephone support.
• Processes invoices and billings; maintains records.
• Maintains unit attendance records, library and/or manuals.
• Records meeting minutes.
• Makes travel arrangements.
• Maintains adequate supply inventory; orders supplies as needed.

• 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.

Workers Compensation Claims Representative

• 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

Claims Examiner – Liability – Midwest Jurisdictions

• To process low level Auto Property Damage 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 with general supervision.
• 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.

Liability Claims Representative – Auto Property Damage

• Analyze and process low to mid-level auto and transportation claims
• 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
• Develop and maintain 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)
• Travels as required

Claims Representative, Auto

Manager

• Perform clinical assessments via telephone calls to evaluate injured workers
• Communicate with claims examiners, clients, attorneys, and injured workers
• Identify and solve issues related to recovery and return to work
• Negotiate treatment and disability duration with providers

Telephonic Case Manager

• 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.
• 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.

Claims Examiner – Liability, License, Bodily Injury Experience

• Analyze complex or technically difficult medical malpractice claims
• Provide resolution of highly complex nature and/or severe injury claims
• Coordinate case management within Company standards
• Manage the total claim costs while providing high levels of customer service

Senior Claims Specialist – Professional Liability

Security Engineer

• To manage and advance the IT security, risk and audit compliance program
• Planning, scheduling, coordinating, reviewing and reporting of the work of the department
• Supervise, coach and train staff
• Develop procedures and audit programs and policies
• Represent Sedgwick IT to clients, carriers and external stakeholders
• Assist IT management on projects as needed
• Performs advanced, specialized and/or managerial IT compliance working the areas of regulatory compliance, data security and protection, risk assessment and risk mitigation
• Manages complex audits both internally and externally including third party vendor audits and client-initiated IT audits
• Performs critical project management duties in the planning, scheduling, coordinating, reviewing and reporting of the work of IT compliance teams
• Provides expertise in IT compliance standards and performance criteria, data security requirements and information technology skills
• Develops and maintains productive internal and external stakeholder relationships
• Communicates with company management clients, carriers, vendors and other stakeholders as needed during IT compliance activities
• Directly interacts with clients, carriers and other external stakeholders in critical or sensitive communications regarding IT compliance and security
• Responds to client, carrier and legal counsel inquiries regarding IT compliance and security matters
• Responsible for teaching, training and coaching staff and for creating appropriate awareness programs within IT and the enterprise
• Develops procedures, schedules, priorities and programs for achieving IT compliance objectives and goals
• Recommends and executes new policies at department and enterprise level
• Prepares audit and compliance reports, analysis and recommendations using advanced writing skills
• Assesses risk factors to identify high risk areas within IT
• Develops risk remediation plans and manages related projects to completion
• Identifies and communicates changes in professional and industry standards, laws, guidelines and audit requirements to department and enterprise personnel
• Consults with and advises administrators, management and staff on various operational control issues related to computerized information systems as needed
• Attends and/or conducts internal and external meetings
• Leads recruitment and hiring of IT audit, compliance and security colleagues
• Attends, presents and/or participates in continuing professional education classes and training courses
• Follows up on audit findings to ensure that management has taken corrective action(s)
• Assists and trains other audit staff in the use of computerized audit techniques and in developing methods for review and analysis of computerized information systems

IT Security Manager

Software Engineer

• Manages the full lifecycle of software development, including design, coding, maintenance, testing, and debugging, to ensure technical excellence and alignment with business needs.
• Provides guidance and training to the development team, fostering a culture of continuous learning and professional growth.
• Ensures successful completion of projects that meet defined goals, quality standards, and comply with company policies and procedures.
• Cultivates proactive and cooperative relationships with IT peers to promote cross-functional collaboration and shared success.
• Remains accessible to all project team members, supporting open communication and timely resolution of issues.
• Monitors advancements in AI technologies applicable to software development and ensures developers actively integrate these tools into their workflows.
• Supports the ongoing development of team members by offering consistent feedback, coaching, and opportunities for skill enhancement.

IT Software Development Manager

• Attendance and completion of designated claims professional training program
• Adjusting various levels of workers’ compensation claims under close supervision
• Communicating effectively with injured workers, insureds/employers, medical providers, attorneys, and carrier representatives
• Investigating new and existing claims by gathering relevant information
• Determining coverage, compensability and appropriate benefits
• Documenting claims files and preparing detailed reports

Claims Representative – Workers Compensation Training Program

• To create profitable growth by acquiring and maintaining new and existing client relationships and increasing market presence by utilizing superior, innovative and personalized service.
• Develops and implements annual business plans and delivers profitable growth of the business’ operating revenues and earnings budget utilizing Sedgwick’s business processes.
• Generates and establishes talent, management, and financial control plans to secure successful execution of a region’s performance.
• Oversees activities of assigned property and casualty staff to ensure efficient operation of branch.
• Facilitates communication between internal and external customers.
• Monitors work product for validity and accuracy to ensure it is delivered technically and grammatically correct to the intended audience.
• Creates and maintains an environment of customer and colleague satisfaction.

Regional Manager

Claims Examiner – Workers Comp, Southeast State Exp

Auditor

• Review Independent Adjuster and Non-Legal Vendor invoices on behalf of clients
• Apply client specified billing guidelines and rate schedules
• Communicate effectively with vendors on compliance
• Manage invoice workflow and finalize vendor invoices for payment
• Work with team members to meet production objectives