Sedgwick

Representative

• Provide disability case management and claim determinations based on complex medical documentation and the applicable disability plan interpretation.
• Determine benefits due and making timely payments/approvals and adjustments.
• Medically manage disability claims; coordinate investigative efforts; thoroughly review contested claims.
• Negotiate return to work with or without job accommodations.
• Evaluate and arrange appropriate referral of claims to outside vendors.
• Communicate clearly with claimant and client on all aspects of claims process either by phone and/or written correspondence.
• Inform claimants of documentation required to process claims, required time frames, payment information and claims status.

Senior Disability Representative

Learning and Development

• To design training courses and materials in compliance with the process of learning using eLearning tools; assists with organizing and conducting training using a webinar tool and tests learning deliverables ensuring performance improvement in line with business goals.
• Designs courseware including scrip writing, storyboards, facilitator guides and participant materials as well as course certification in compliance with company process of learning.
• Creates and maintains pre-, post-, and behavioral change assessments within each course; uses data to provide statistical proof that course objectives are being achieved.
• Consistently researches technology and media options for effective adult blended learning.
• Creates and maintains training material and ensures that adult learning principles are applied.
• Partners with various subject matter experts to design content, where appropriate.
• Produces and/or creates engaging visual content that will keep concepts fresh and relevant for colleagues.
• Participate in design reviews, revisions, and quality assurance checks.
• Maintain version control and documentation for assigned learning assets.
• Creates and manages development timelines and milestones to ensure all requirements are met.
• Stay informed about instructional design trends, emerging tools, and best practices, including AI platforms such as Co-Pilot and Articulate AI.

Instructional Designer – Learning & Development

Advisor

• To develop targeted solutions and provide added technical guidance and oversight to ensure matters are resolved optimally while creating a culture of continual quality improvement designed to elevate the overall claim handling to benefit our stakeholders.
• Proactively and strategically manages a complex claim inventory by assessing complex claims issues, utilizing jurisdictional expertise to provide oversight, and directs the handling to achieve the best possible resolution.
• Acts as the organizational subject matter expert for line of business and key jurisdictions on complex claim issues.
• Articulates and documents clear and concise file notes to allow stakeholders to understand the issues and path to resolution.
• Facilitates roundtables with groups/teams; engages appropriate internal and external resources as needed.

Complex Claims Advisor – Product Liability, GL

General

• To provide carrier support by assisting payments department and management with identifying carrier issues/concerns.
• Acts as the liaison between carriers and Property Repair Solutions internal payment team to research, review and resolve issues for carrier-related requests.
• Support and promote Sedgwick’s mission, strategic vision, and value proposition to adjusters and policyholders.
• Serve as a key point of contact for policyholders during their relocation, ensuring consistent communication, clear expectations, and empathetic support.
• Qualify housing needs by gathering details about the insured’s lifestyle, household makeup, accessibility needs, pet considerations, and preferred amenities.
• Conduct detailed market research using listing platforms, vendor databases, and internal tools to locate viable, like-kind-and-quality housing options.
• Collaborate with corporate and independent housing vendors, landlords, and leasing agents to secure short-term rentals under time-sensitive circumstances.
• Apply negotiation skills to secure favorable lease terms, maximize policy benefits, and stay within Additional Living Expense (ALE) guidelines.
• Customize housing options that align with both policy coverage and the insured's expectations—balancing budget, availability, and quality.
• Maintain high touch service throughout the policyholder’s stay, proactively resolving issues and supporting lease extensions, furniture adjustments, and service needs.
• Draft and review lease agreements and related documents with attention to detail and policy compliance.
• Enter and maintain accurate data in housing databases, CRM tools, and internal platforms.
• Stay informed of local rental trends, landlord regulations, and insurance housing best practices to advise clients and partners effectively.
• Handle multiple claims and assignments at once with professionalism and urgency.
• Serves as the point of contact for VIP clientele.

Housing Coordinator

• Review all estimates and supporting documentation submitted by contractors/adjusters
• Ensure estimates follow client and regulatory requirements
• Serve as a subject matter expert on property restoration scope

Senior Estimate Review Specialist – Repair Solutions

Client Services Representative

• To determine account management strategies related to client service plans;
• To be responsible for retention of existing clients, customer satisfaction, revenue growth, client surveys, and new business;
• To provide program management for jumbo clients requiring dedicated staff, multiple offices and complex service models;
• To oversee the work of other local Client Services staff.

Director Client Services

Consultant

• Responsible for cradle to grave management of environmental incidents.
• Supervision of site investigations to establish potential contamination.
• Identifying environmental risks associated with incidents.
• Deliver site remediation goals across a variety of different sites.
• Collaborate with Senior Management Team and contractors for project goals.
• Opportunity to assist in desktop consulting for incidents globally.

Environmental Consultant

Claims Specialist

• To analyze mid- and higher-level property damage liability claims to determine benefits due;
• Ensure ongoing adjudication of claims within company standards and industry best practices;
• Identify subrogation of claims and negotiate settlements.
• Manages mid-level property damage 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.
• Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
• Communicates claim action with claimant and client.

Claims Adjuster – Liability, Property Damage

Team Lead

• To ensure efficient, cost effective, and high quality delivery of case management services to clients for multiple business lines by supervising and training multiple units of colleagues located on-site at client locations
• Overseeing the management of cases worked by field specialists
• Providing expertise in client union involvement and client specific case management requirements
• Ensuring customer satisfaction through the provision of these services and through dealing directly with multiple business line claims managers, supervisors and examiners utilizing the account management process.

Clinical Team Lead – Senior

• To manage accounts of multiple client service programs or single large national program
• To maintain client, client broker and key vendor relationships
• Manage program procedures and processes that impact customer satisfaction ensuring consistency in process within the account as well as client retention
• Performs client renewal and Client Service Instruction preparation for assigned clients
• Coordinates pricing and completes location coding parameters; prepares and distributes stewardship and other reports
• Coordinates client invoicing, audits and accounts receivable follow-up for assigned clients
• Educates the client on loss data - drivers of cost impacting assigned programs
• Coordinate project activity
• Acts as primary client contact with focus on maintaining and improving overall customer satisfaction
• Identifies issues that impact customer satisfaction
• Identifies and solicits cross selling opportunities
• Coordinates client contracts
• Performs other duties as assigned
• Supports the organization's quality program(s)
• Travel as required

Manager, Client Services – Workforce Absence

• Analyzes reported leave requests including Family Medical Leave (FMLA), unpaid state, military and company-specific, to make determinations based on client plans, state and federal regulations
• Ensures that on-going claim management is within company service standards and industry best practices
• Establishes FMLA and other unpaid state, military, and/or company-specific leave claims; tracks and codes documentation in accordance with internal workflow processes
• Analyzes FMLA and other unpaid claims to determine eligibility and certification in compliance with client plans, state and federal regulations
• Reviews claim information received to identify action plan, determine benefits due, and make timely case decisions based on plan descriptions and service expectations as established by the client
• Communicates decisions and on-going expectations clearly and professionally with claimants and clients by phone, written correspondence and/or claims system
• Maintains professional client relationships and provides excellent customer service
• Meets the organization’s quality program(s) minimum requirements

Leave of Absence Coordinator

Adjuster

• Independently investigate and manage a full caseload of CGL claims
• Drive timely claim resolution through proactive file management, strategic planning, and adherence to best practices
• Analyze complex policy language, including insuring agreements and endorsements
• Conduct comprehensive liability investigations and evaluate injury severity
• Manage litigated files and provide strategic oversight on litigation plans
• Negotiate settlements within delegated authority
• Maintain proactive, professional communication with insureds, claimants, brokers, clients, and internal stakeholders
• Ensure compliance with applicable state regulations and client service instructions

Construction Defect Adjuster

• Analyze reported leave requests and determine paid leave benefits due based on client paid leave plans
• Make timely calculations, payments and/or adjustments for client paid leave plans
• Ensure ongoing claim management is within company service standards and industry best practices
• Establish FMLA claims and track documentation in accordance with internal workflow processes
• Communicate decisions and ongoing expectations with claimants and clients

• To analyze Lost-Time 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 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.

Workers Compensation Claims Examiner – DE License Preferred

• Supervise the operation of multiple teams of examiners and technical staff for liability claims for clients.
• Monitor colleagues' workloads, provide training, and monitor individual claim activities.
• Provide technical/jurisdictional direction to examiner reports on claims adjudication.
• Maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims.
• Identify and advise management of trends, problems, and issues as well as recommended course of action.
• Perform quality review on claims in compliance with audit requirements, service contract requirements, and quality standards.
• Act as second level of appeal for client and claimant issues regarding claim specific, procedural or special requests.
• Review reserve amounts on high cost claims and claims over the authority of the individual examiner.
• Maintain contact with the client on claims and promote a professional client relationship.

Senior Disability Representative

Instructional Designer – Learning & Development

Complex Claims Advisor – Product Liability, GL

Housing Coordinator

Senior Estimate Review Specialist – Repair Solutions

Director Client Services

Environmental Consultant

Claims Adjuster – Liability, Property Damage

Clinical Team Lead – Senior

Manager, Client Services – Workforce Absence

Leave of Absence Coordinator

Construction Defect Adjuster

Leave of Absence Coordinator

Workers Compensation Claims Examiner – DE License Preferred

Claims Team Lead, Auto – Bodily Injury