Sedgwick

Vice President

• Responsible for overall operations management for all locations/offices within an area.
• 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 assigned area and locations/offices.
• Monitors management reports relating to the area/office performance.
• Assists with the coordination of sales and client service efforts including oral presentations.
• Supports the organization's quality program(s).
• Travels as required.
• Administers company personnel policies in all areas and follows company staffing standards and training recommendations.
• Interviews, hires and establishes colleague performance development plans; conducts colleague performance reviews.
• Provides support, guidance, leadership and motivation to promote maximum performance.

Assistant Vice President, Claims

Payroll

• To process payroll actions based on changes in leave status.
• To ensure the accurate and timely entry of data.
• Support delivery of the highest quality of customer service as a point of contact for internal and external customers and clients.
• Ensures data integrity by accurately interpreting the leave and disability claims data coding hierarchy and applying the correct leave and disability codes into the payroll and time and attendance system.
• Review reports for claim accuracy; processes and balances colleague time card file based on client's paid time off policy.
• Responds to inquiries from Human Resources and internal business partners regarding plan provisions and administrative procedures
• Assists department in evaluating results of absence programs and best practices in absence administration.
• Assists management with special projects as assigned.

Workforce Absence Payroll Coordinator

Claims Specialist

• Adjusts medical-only claims and minor lost-time workers compensation claims under close supervision.
• Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.
• Processes workers compensation claims determining compensability and benefits due; monitors reserve accuracy, and files necessary documentation with state agency.
• Communicates claim action/processing with claimant, client and appropriate medical contact.
• Ensures claim files are properly documented, and claims coding is correct.
• May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.
• Maintains professional client relationships.

Workers Compensation Claims Associate, Medical Only

Operations

• To be responsible for the technical and operational functions for multiple offices.
• Handle staffing and training needs within assigned offices.
• Responsible for budget preparation and profit and loss management for assigned office(s).
• Oversee overall operations management for all locations/offices within an area.
• Establish business plan with goals and objectives for the area and locations/offices.
• Monitor and take appropriate action on management reports relating to the area/office performance.
• Assist with the coordination of sales and client service efforts.

Vice President, Operations – Casualty

• To analyze 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.

Claims Examiner – Workers Compensation

Client Services Representative

• To be responsible for the administrative, managerial and client relationships associated with Client Services within the assigned area.
• Ensures contract compliance with company guidelines within an assigned area.
• Handles financials including accounts receivable, invoicing and pricing support within an assigned area.
• Responsible for client knowledge including threatened status and relationship with the company.
• Handles renewal process timely; negotiates new contracts within an assigned area.
• Responsible for business planning and budgeting within an assigned area.
• Plans for staffing needs including succession, bench-strength, and new business within an assigned area.
• Supports client relationships; builds executive relationships; supports internal relationships.
• Supports business development.

AVP Client Services

• Analyze low- and mid-level workers compensation claims to determine benefits due
• Ensure ongoing adjudication of claims within company standards and industry best practices
• Adjust medical-only claims and low- to mid-level lost-time workers compensation claims under close supervision
• Support other claims staff with larger or more complex claims as necessary
• Process workers compensation claims reviewing compensability, benefits due, and files necessary documentation with state agency
• Communicate claim action/processing with appropriate parties including, but not limited to: claimant, client, state agency, managed care organization and appropriate medical contact
• Ensure claims files are properly documented and claims coding is correct
• Maintain professional client relationships
• Coordinate actuarial/settlement issues impacting employers with rate and settlement departments

Specialty Operations Coordinator

• Independently handle a capped caseload of workers' compensation claims, from inception to resolution, ensuring adherence to company procedures, industry best practices, and regulatory requirements.
• Ensure compliance with New York workers' compensation laws, including timely filing of reports, adherence to benefit payment timelines, and compliance with statutory requirements.
• Negotiate settlements of claims within designated authority to reach claim resolution.
• Provide clear and effective communication with the claimant and client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
• Maintain accurate and comprehensive records in the claims management system, documenting all actions, decisions, and correspondence related to each claim.

Workers Compensation Claims Examiner

AI Engineer

• Lead the architecture and delivery of enterprise-grade LLM and agentic AI systems that transform claims, risk, and operational workflows.
• Define technical strategy for retrieval-augmented generation (RAG), multi-agent orchestration, and autonomous workflow automation.
• Design and implement advanced agentic systems capable of planning, reasoning, tool selection, execution, reflection, and recovery.
• Architect stateful, memory-aware AI systems that manage long-running claims processes across multiple touchpoints.
• Build multi-agent collaboration models that coordinate coverage analysis, document validation, fraud signals, compliance checks, and decision support.
• Establish orchestration frameworks that manage task routing, context persistence, structured outputs, and failure handling.
• Design secure tool integration layers connecting agents to claims systems, policy platforms, data warehouses, document repositories, and external data services.
• Implement deterministic guardrails, schema validation, and output verification pipelines to reduce hallucination and execution risk.
• Lead development of document intelligence systems leveraging LLMs for summarization, entity extraction, discrepancy detection, and structured data reconstruction.
• Define prompt engineering standards and reusable reasoning templates for consistent, domain-aware outputs.
• Oversee embedding strategies, vector indexing architecture, retrieval optimization, and knowledge grounding approaches.
• Design evaluation frameworks to measure reasoning depth, workflow completion accuracy, hallucination rates, latency, and cost efficiency.
• Implement observability layers that track agent decisions, tool usage, retrieval effectiveness, and drift across models and prompts.
• Drive optimization strategies for token efficiency, caching, batching, and inference scaling.
• Ensure compliance with Responsible AI principles, enterprise governance standards, audit requirements, and regulatory constraints.
• Partner with enterprise architecture, cybersecurity, and data governance teams to define secure deployment patterns.
• Mentor engineers on LLM orchestration patterns, workflow decomposition, and safe agent design.
• Translate executive-level business objectives into scalable AI platform capabilities.
• Lead proof-of-concepts through full production deployment with measurable ROI outcomes.
• Continuously evaluate emerging foundation models, orchestration frameworks, and agent tooling for enterprise readiness.

Senior Applied AI Engineer

• To 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.
• Develops and maintains 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

• To analyze 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 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.

• To analyze mid- and higher-level workers compensation claims to determine benefits due
• Ensure ongoing adjudication of claims within company standards and industry best practices
• Identify subrogation of claims and negotiate settlements
• Develops and manages workers compensation claims' action plans to resolution
• Communicates claim action with claimant and client

Workers Compensation Claims Adjuster

• To analyze complex or technically difficult workers' compensation 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.
• 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.

• Analyze 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.
• 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.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

• 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 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.