Sedgwick

Representative

• Negotiate Workers' Compensation medical liens following unit guidelines, in house resolution unit.
• To represent client employers at hearings before the appropriate judicial body.
• Handle all aspects of research, file review, and negotiation of outstanding medical lien.
• Prepare lien settlements.
• Performs lien negotiations. Reviews upcoming hearings and prepares necessary documentation to represent clients' interests; supports legal counsel in regard to hearings; appears before the judicial body on behalf of clients.
• Reviews state files to update company files accordingly.

CA Lien Negotiator, Hearing Representative

Adjuster

• Handle losses and claims for property and casualty insurers
• Examine insurance policies and other records to determine insurance coverage
• Interview, telephone, and/or correspond with claimant and witnesses regarding claim
• Consult police and hospital records and inspect property damage to determine company's liability
• Estimate cost of repair, replacement, or compensation
• Prepare report of findings and negotiate settlement with claimant
• Recommend litigation by legal department when settlement cannot be negotiated
• Attend litigation hearings
• Revise case reserves in assigned claims files to cover probable costs

Claims Assistant

• Focus on providing outstanding service and claims administration to our Loss Adjusters
• Set up and enter new claims into the system
• Update the system with review notes and additional inputs
• Process payments
• Manage communications through calls and emails to all stakeholders including the Customers, Brokers and Insurers
• Assist with driving claims to settlement

• Manage high-value and complex liability claims and investigate and handle to settlement a wide range of complex liability claims typically in the areas of Public, Employers, and Products Liability
• Meet with clients to enhance existing relationships in the local/national markets and build new relationships

Complex Liability Adjuster

• To provide excellent service displaying empathy to callers regarding claims for multiple lines of business, including but not limited to, expediting the claims process and providing detailed claim notes on all calls
• Acts as primary liaison with callers from multiple client accounts within a shared services environment
• Follows specifications in assisting with questions and solving problems related to the claims application and servicing processes
• Performs claim intake and full-service customer support within regulatory requirements, company, and client expectations at all times
• Educates and informs the customer about documentation required to file/process a claim, required time frames, payment information, and claim status
• Educates claimants/callers on client requirements and benefit plans documenting all required details of the call in a concise professional manner
• Enters verbal and written claim information that meets both the internal and external customer’s requirements accurately into the appropriate system
• Directs customer calls to the appropriate contact at multiple locations or escalates to Service Center Specialist/management as needed
• Attendance during scheduled work hours is required

Care Team Representative

Claims Specialist

• To analyze General Liability & Auto BI (Litigated & Non-Litigated), Premises claims.
• Determine benefits due while ensuring ongoing adjudication of claims.
• Analyzing and processing claims through well-developed action plans.
• 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.

Liability Claims Examiner – General Liability, Auto BI – License Required

Product Manager

• The Product Manager represents the “voice of the client” by maintaining and prioritizing the product backlog
• Translates client needs into clear, actionable requirements
• Solicits stakeholder input and feedback to inform product decisions
• Partners closely with the development team to balance functional outcomes with technical feasibility
• Defines product outcomes (OKRs) and communicates roadmap progress, risks, and dependencies to stakeholders
• Estimates effort required to complete requests and allocates capacity accordingly
• Collaborates with Operations, Sales, and Product leadership to ensure strategic alignment
• Works with the Product Director to adjust scope, sequencing, and roadmap decisions

• Analyze Workers Compensation claims on behalf of our valued clients to determine benefits due.
• Ensure 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.

Claims Examiner – Workers Compensation

General

• Triage calls to assess needs and give appropriate care advice
• Identify needs of callers and refer to appropriate level of care
• Demonstrate effective verbal communication skills
• Adhere to quality assurance standards

RN Clinical Consultation

• Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation including determining benefits due and making timely payments/approvals and adjustments
• Medically managing disability claims including comorbidities, concurrent plans, and complex ADA accommodations
• Coordinates investigative efforts, thoroughly reviews contested claims, negotiates return to work with or without job accommodations, and evaluates and arranges appropriate referral of claims to outside vendors

Senior Disability Representative

Manager

• manage the technical and operational functions within assigned office(s)
• ensure consistent delivery of quality services
• responsible for staffing and training needs
• responsible for budget preparation and profit and loss management
• establish policy and procedure to assure compliance to best practices
• monitor management reports relating to performance
• coordinate sales and client service efforts
• administer company personnel policies

Claims Manager – Auto, Bodily Injury & Property Damage

Marketing

• Creates unique, strategic marketing collateral to meet the needs of a variety of clients.
• Responsible for design and marketing support for strategic marketing plans, working with in-house and outside resources to create high-impact materials programs to acquire and retain Sedgwick Pooling customers across all lines of business.
• Responsible for creating and developing content developed for Sedgwick services and/or Pooling clients.
• Leads strategic marketing campaigns with a variety of digital promotions, which may include branding, email blasts/newsletters, webinars, flyers, promotions, marketing campaigns, and website optimization.
• Strategizes with management to analyze effective marketing campaigns through the use of data analytics with the ability to pivot toward optimization for further engagement.
• Edits and proofreads marketing collateral.
• Conducts research, analysis, logistics, and overall coordination of projects with internal and external stakeholders.
• Maintains a working knowledge of all aspects of the business and ancillary services such as alternative risk to support national marketing programs.

Marketing Consultant

Business Analyst

• The Sr Business Analyst supports product teams by translating business needs and product priorities into detailed, actionable requirements and execution plans.
• Partnering closely with the Product Manager, this role refines and manages the product backlog, supports prioritization, and ensures delivery aligns with intended business outcomes.
• The Business Analyst may execute delegated Product Manager activities when capacity or capability constraints exist and play a key role in validating delivered functionality, tracking outcomes, and supporting product execution.
• Partners with Product Managers on backlog refinement and prioritization, including sequencing work based on value dependencies and capacity.
• Defines the development-ready stories and requirements by breaking down epics and features into user stories, defines acceptance criteria, and documents high‑level non‑functional requirements.
• Executes the delegated Product Managers’ responsibilities when the PM capacity or capability is limited, ensuring continuity of product execution.
• Collaborates with development teams and Solution Architects to ensure stories are well understood and aligned with business outcomes.
• Validates solutions aligned to the business units by participating in and supporting User Acceptance Testing to confirm delivered functionality meets defined requirements and acceptance criteria.
• Measures visibility into delivery and outcomes by tracking and reporting on stakeholders to surface risks, dependencies, and performance insights.

Senior Business Analyst

• Represents the 'voice of the client' by maintaining and prioritizing the product backlog that maximizes business value.
• Translates client needs into clear, actionable requirements.
• Solicits stakeholder input and feedback to inform product decisions.
• Partners closely with the development team to balance functional outcomes with technical feasibility.
• Manages dependencies and supports predictable delivery.
• Performs external and internal discovery to identify client needs, market opportunities, and business priorities.
• Collaborates with Operations, Sales, and Product leadership to ensure strategic alignment.