Sedgwick

Claims Specialist

• To analyze Workers Compensation Lost-Time claims on behalf of our valued clients to determine benefits due.
• Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims.
• Develops and coordinates low level workers compensation claims' action plans to resolution.
• Communicates claim action with claimant and client.
• Maintains professional client relationships.

Workers Compensation Claims Representative, NY Jurisdictional Experience

• Analyzes and processes complex claims
• Works with high exposure claims involving litigation
• Ensures ongoing claims within service expectations, industry best practices and specific client service requirements
• Identifies and pursues potential third-party subrogation recoveries associated with highest exposure/complexity claims
• Reviews high exposure, complex multi-jurisdictional claims to establish potential for third party subrogation recovery
• Provides subrogation guidance and direction to both internal and external stakeholders
• Develops and pursues third party subrogation
• Sends appropriate subrogation lien notifications to appropriate parties
• Gathers information necessary to support viable subrogation claims
• Provides direction to assigned subrogation counsel
• Maintains a diary on active claims with subrogation potential
• Approves and makes timely claim payments relative to subrogation
• Manages claim recoveries, including but not limited to subrogation
• Prepares status reports for clients as required
• Manages the litigation process
• Develops training material and leads department training opportunities.

Claims Representative, Recovery

• To analyze Medical Only & Lost-Times Workers Compensation claims on behalf of our valued clients to determine benefits due.
• Ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution.
• 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 Adjuster

Business Analyst

• Analyze complex datasets to identify trends, patterns, and performance opportunities, translating findings into clear business insights and recommendations.
• Partner with business leaders and subject‑matter experts to define problems, shape analytical approaches, and influence strategic decisions.
• Design, develop, and optimize analytical datasets and data models in Snowflake to support scalable reporting and insight generation.
• Write complex SQL queries and leverage Python to extract, transform, and analyze data, enabling deeper business understanding.
• Build and maintain Power BI dashboards that not only report metrics but highlight key insights, risks, and opportunities.
• Use modern analytics tools (e.g., Hex) to perform exploratory analysis and develop repeatable workflows that support ongoing business evaluation.
• Translate analytical findings into clear, concise, and actionable recommendations for leadership and cross‑functional teams.
• Ensure data accuracy and integrity through validation, documentation, and adherence to governance standards.
• Act as a trusted advisor by connecting data insights to business strategy and operational improvements.
• Mentor junior analysts on both technical skills and insight generation best practices.

Senior Business Analyst – Data & Insights

Content Marketing Manager

• Prepares reports and correspondence to customers, other VeriClaim adjusters, and/or insureds.
• Evaluates residential and commercial contents inventories obtained by or submitted to VeriClaim on both a replacement cost and actual cash value basis.
• Applies limitations and/or exclusions based on coverage afforded by the policy.
• Finalizes inventory in preparation of reporting including: preparing enclosures, preparing letters, and making detailed notes for reporting purposes.
• Facilitates the use of replacement services as requested by the Contents Adjuster.
• Reviews and processes replacement receipts.
• Communicates with colleagues, management, customers, and insureds in a courteous and professional manner.
• Conforms with and abides by all regulations, policies, work procedures, and instructions.

Contents Evaluator Associate

• Analyze Lost-Time Workers Compensation claims on behalf of clients to determine benefits due.
• Ensure ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Workers Compensation Claims Adjuster – CT, MA Jurisdictions, CT License

• To analyze Auto, General Liability & Product Liability claims on behalf of our valued clients.
• Determine benefits due while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.

Commercial Liability Claims Examiner – Auto, General Liability & Product Liability

Director

• To manage the technical and operational functions within assigned Professional Liability offices with 75 or more 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 area and locations/offices
• Monitors management reports relating to the area/office performance
• Provides support, guidance, leadership and motivation to promote maximum performance

Claims Director, Professional Liability

• Analyze mid- and higher-level general auto claims to determine scope of damages
• Ensure ongoing adjudication of claims within company standards and industry best practices
• Identify subrogation of claims and negotiate settlements
• Manage mid-level and higher-level auto commercial and personal lines claims by gathering information to determine exposure
• Assign reserve values to claims, make claims payments as necessary, and settle claims up to designated authority level
• Assess liability and resolve claims within evaluation
• Approve and process assigned claims, determine benefits due, and manage action plan pursuant to the claim or client contract
• Manage subrogation of claims and negotiate settlements
• Communicate claim action with claimant and client
• Ensure claim files are properly documented and claims coding is correct
• Maintain professional client relationships
• Perform other duties as assigned

Claims Adjuster, Auto – Property Damage

Operations

• To analyze complex or technically difficult general liability claims to determine benefits due.
• Manage claims through well-developed action plans to an appropriate and timely resolution.
• Assess liability and resolves claims within evaluation.
• Negotiate settlement of claims within designated authority.
• Calculate and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
• Manage the litigation process; ensures timely and cost-effective claims resolution.
• Communicate claim activity and processing with the claimant and the client; maintains professional client relationships.

Claims Examiner – Product, Premise & Completed Operations Liability

• To analyze and process complex bodily injury auto and commercial transportation claims by reviewing coverage
• Completing investigations
• Determining liability and evaluating the scope of damages
• Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly
• Responsible for litigation process on litigated claims
• Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims
• Reports large claims to excess carrier(s)
• Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution
• Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage
• Communicates claim action/processing with insured, client, and agent or broker when appropriate

Claims Examiner, Auto – Bodily Injury

• Provides strategic leadership and oversight for a Large National Client program across both operational execution and client service delivery
• Directly oversees the GL Non-Litigation Claims Manager and GL Litigation Supervisor to ensure alignment across litigated and non-litigated operations
• Leads operational performance management activities including claim quality, inventory management, cycle time, litigation trends, and financial outcomes
• Oversees client stewardship, operational reporting, analytics, and presentation of program performance and strategic initiatives
• Partners with client stakeholders and internal operational leadership to develop, implement, and monitor program improvement initiatives
• Translates operational and financial data into actionable insights and strategic recommendations to improve claim outcomes and operational effectiveness
• Serves as the primary coordination point between operations, analytics, client stakeholders, and executive leadership to ensure consistent execution of program objectives
• Performs other duties as assigned. Supports the organization's quality program(s). Travels as required.

Director of Operations Strategy – General Liability

Manager

• To lead and oversee the non-litigated General Liability claims operations for a Large National Client by managing operational leadership teams, driving technical consistency, supporting claim quality initiatives, and ensuring high-quality claim and client outcomes.
• Oversees day-to-day operations of the non-litigated General Liability claims program for a Large National Client.
• Provides leadership and direction to Non-Litigation Team Leaders responsible for claim inventory management and examiner performance.
• Maintains oversight of the full non-litigated GL claim inventory and operational performance across the program.
• Monitors operational metrics including inventory management, closure rates, cycle time, claim quality, pending management, and customer service outcomes.
• Ensures compliance with client handling instructions, jurisdictional requirements, corporate standards, and best practices.
• Directly supervises Non-Litigation Team Leaders supporting the Large National Client GL program.
• Provides indirect oversight for non-litigated claim examiner teams.
• Supports staffing strategy, succession planning, colleague development, and performance management within the non-litigation organization.
• Provides coaching, technical guidance, and leadership support to strengthen claim handling quality and operational consistency.
• Promotes a collaborative, accountable, and client-focused culture across the non-litigation teams.
• Supports consistency in liability analysis, investigation quality, reserving practices, and claim resolution strategies.
• Partners with Team Leaders and examiners to drive timely and effective claim resolution.
• Identifies trends, operational challenges, and emerging exposures within the non-litigated claim portfolio.
• Collaborates with litigation leadership and executive leadership to support escalation management and transition of claims into litigation when appropriate.
• Supports implementation of best practices and continuous improvement initiatives across the program.
• Supports client relationships through operational transparency, responsiveness, and proactive issue resolution.
• Participates in client meetings, stewardship discussions, and operational reviews as needed.
• Partners with client-facing leadership to ensure alignment between operational execution and client expectations.
• Supports delivery of operational insights, trend analysis, and performance improvement initiatives.
• Monitors operational performance, indemnity trends, expense management, and claim outcomes across the non-litigated portfolio.
• Utilizes reporting and analytics to identify trends, measure performance, and drive operational improvements.
• Supports operational planning, staffing strategy, workload balancing, and resource allocation within the non-litigated organization.

Claims Manager – General Liability, Non-Litigation

Data Analyst

• To collect, analyze and report data; to be responsible for the data integrity; and to generate reports verifying and ensuring data integrity and accuracy.
• Compiles data; prepares and distributes reports; and analyzes results.
• Ensures data integrity; develops and produces reports utilized in measuring data accuracy.
• May assist in the completion of appropriate client set-up and maintenance (parameter) forms.
• Supports internal and external users including reports, installation, screen, etc.
• Creates exception reports to identify fields of incorrect data.
• Generates custom reports for internal and external client.

Consultant

• Triages substantial residential and commercial property losses by assessing job needs and determining which contractor(s) will be assigned to the jobs.
• Serves as the point of contact for high net worth clientele.
• Responsible for dispatching and coordinating multiple trades on large jobs with repair plans.
• Coordinates with other support departments to ensure seamless transactions for clients monitoring the job throughout the entire process to ensure adherence to procedures of the referring client.
• Assists with special projects and training of new colleagues on processes and systems.
• Attendance during scheduled work hours is required.