Sedgwick

Claims Specialist

• To analyze Auto Bodily Injury and Property Damage 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.

Liability Claims Examiner – Auto PD, BI

• Analyzes and processes complex or technically difficult workers' compensation 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.
• Negotiates settlement of claims within designated authority.
• Calculates and assigns timely and appropriate reserves to claims;
• Manages reserve adequacy throughout the life of the claim.
• Calculates and pays benefits due;
• Approves and makes timely claim payments and adjustments;
• Settles claims within designated authority level.
• Prepares necessary state fillings within statutory limits.
• Manages the litigation process;
• Ensures timely and cost effective claims resolution.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
• Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
• Reports claims to the excess carrier;
• Responds to requests of directions in a professional and timely manner.
• Communicates claim activity and processing with the claimant and the client;
• Maintains professional client relationships.
• Ensures claim files are properly documented and claims coding is correct.
• Refers cases as appropriate to supervisor and management.
• Performs other duties as assigned.
• Supports the organization's quality program(s).

Claims Examiner – Workers Compensation

• Analyzes and processes complex or technically difficult workers' compensation 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.
• Negotiates settlement of claims within designated authority.
• Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
• Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles claims within designated authority level.
• Prepares necessary state fillings within statutory limits.
• Manages the litigation process; ensures timely and cost-effective claims resolution.
• Coordinates vendor referrals for additional investigation and/or litigation management.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
• Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries, and Social Security and Medicare offsets.
• Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
• Ensures claim files are properly documented and claims coding is correct.
• Refers cases as appropriate to supervisor and management.

Claims Examiner – Workers Compensation, TX preferred

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.
• Performs other duties as assigned.
• 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.

AVP Client Services – Workforce Absence

Product Manager

• The Product Manager represents the “voice of the client” and is accountable for delivering measurable business value through data products.
• This role partners with clients and internal stakeholders to identify needs, define product opportunities, and translate them into actionable requirements.
• The Product Manager owns the product backlog, roadmap, and outcomes, ensuring alignment between business priorities, client impact, and technical feasibility while supporting predictable delivery.
• Performs external and internal discovery to identify client needs, market opportunities, and business priorities, incorporating technical constraints, platform standards, and architectural considerations into product direction.
• Collaborates with Operations, Sales, and Product leadership to ensure strategic alignment, secure sign‑off on key business decisions, and balance functional and technical tradeoffs.
• Defines and tracks product success metrics (e.g., adoption, usage, NPS, revenue/retention impact), represents the 'voice of the client,' and communicates roadmap progress, risks, and dependencies to stakeholders.
• Works with technical resources on Data Products team to estimate effort required to complete requests and allocates capacity accordingly.
• Participates in end-to-end product design activities, ensuring solutions are intuitive and aligned with client workflows.

Product Manager – Data Products

• To analyze mid-level commercial auto physical damage and total loss claims to determine scope of damages.
• Assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.
• Receive and review new claims and maintain data integrity in the claims system.
• Conduct claim file activities including evaluations, investigations, litigation management and resolution.
• Review investigative reports, insurance policies and other pertinent records for proper coverage.
• Investigate the cause and extent of the damages, obtain appropriate documentation and issue settlement.
• Determine coverage of claims with proper limits and deductibles in accordance with policy information.
• Prepare settlement documents and requests payment for the claim and expenses.
• Work with external vendors and professionals.
• Interview and correspond with claimant and witnesses regarding claims.
• Estimate cost of repair, replacement or compensation.
• Prepare report findings and negotiate settlements with claimants.
• Recommend litigation by legal department when settlement cannot be negotiated.
• Revise case reserves in assigned claims files to cover probable costs.
• Assist in preparing loss experience report to help determine profitability and calculate adequate future rates.

Claims Adjuster - Liability, PD / TL

Events

• Provide excellent service displaying empathy to callers regarding claims for multiple lines of business
• Expedite the claims process and provide detailed claim notes on all calls
• Resolve issues with one call/one person response
• Direct calls to appropriate escalation path as needed
• Act as primary liaison with callers from multiple client accounts within a shared services environment
• Follow specifications in assisting with questions and solving problems related to the claims application and servicing processes
• Perform claim intake and full-service customer support within regulatory requirements, company, and client expectations at all times
• Educate and inform the customer about documentation required to file/process a claim
• Educate claimants/callers on client requirements and benefit plans documenting all required details of the call in a concise professional manner
• Enter verbal and written claim information that meets both the internal and external customer’s requirements accurately into the appropriate system
• Direct customer calls to the appropriate contact at multiple locations or escalate to Service Center Specialist/management as needed.

Career Starter

Security Engineer

• Manage and advance the IT security, risk and audit compliance program
• Supervise, coach and train staff
• Develop procedures and audit programs and policies
• Represent Sedgwick IT to clients, carriers and external stakeholders

IT Security Manager

• 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 Examiner – NY Lost-Time Experience, NY Licensing Required

• Analyzes and processes complex or technically difficult workers' compensation 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.
• Negotiates settlement of claims within designated authority.
• Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
• Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
• Prepares necessary state fillings within statutory limits.
• Manages the litigation process; ensures timely and cost effective claims resolution.
• Coordinates vendor referrals for additional investigation and/or litigation management.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
• Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
• Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
• Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
• Ensures claim files are properly documented and claims coding is correct.
• Refers cases as appropriate to supervisor and management.
• Performs other duties as assigned.
• Supports the organization's quality program(s).
• Travels as required.

Claims Examiner – Workers Compensation, Southeast Exp Preferred, Licensing: NC

• To analyze mid- and higher-level general auto claims to determine scope of damages.
• To ensure ongoing adjudication of claims within company standards and industry best practices.
• To identify subrogation of claims and negotiate settlements.
• Manages mid-level and higher-level auto commercial and personal lines claims by gathering information to determine exposure.
• Assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.
• Assesses liability and resolves claims within evaluation.
• Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
• Manages subrogation of claims and negotiates settlements.
• Communicates claim action with claimant and client.
• Ensures claim files are properly documented and claims coding is correct.
• Maintains professional client relationships.

Auto Claims Adjuster

• To address and handle high end General Liability cases with serious injuries, complex coverage scenarios and legal inquiries or disputes; to develop a strategy to bring a case to satisfactory resolution.
• Reviews/acts on reports/forms; responds to inquiries; seeks legal opinion and early resolution; and communicates resolution to appropriate parties.
• Handles high end cases with serious injuries and/or complex coverage scenarios.
• Responds to decisions, agreement, and/or court order; creates action plan; determines need for examination; gains client authorization.
• Identifies cases for settlements/redemptions.
• Gathers/documents additional information and coordinates with client designees.
• Requests legal/private investigation; assigns to and coordinates with local counsel; monitors local counsel performance.
• Responds to plaintiff's counsel, union, employee, or client requests.
• Identifies issues and formulates defense strategy.
• Establishes/adjusts accrued liability and approves administrative expenses.
• Identifies subrogation opportunities and manages process.
• Attends and participates in mediations, trials, arbitrations or hearings as needed.
• Works with partners to affect early return-to-work.

Litigation Claims Examiner – General Liability

Operations

• To support Operations Support Services leadership relating to all aspects of quality assurance
• Ensure service level agreements are maintained
• Research and resolve complex technical issues
• Manage and create escalation procedures
• Track and monitor issues ensuring a timely resolution
• Perform monthly quality and technical audits
• Provides leadership, direction, and support to a team of OSS colleagues
• Assigns and monitors workload for OSS colleagues; coordinates project volume and assignments
• Ensures that processes and procedures are adhered to and that department objectives and Service Level Agreements (SLAs) are met
• Assists leadership to establish departmental procedures, standards, and metrics
• Supports OSS Coordinators and OSS Associates by providing advice on handling complex issues
• Tracks non-compliance issues and monitors through to resolution
• Acts as quality assurance by identifying, researching, resolving and responding to technical and non-technical issues or questions
• Communicates high visibility issues to immediate supervisor
• Maintains high level of knowledge of applicable claim systems, processes, and procedures to assist in a resolution to customer issues
• Escalates calls to the appropriate departments as needed
• Provides status and follow-up information to customers as needed
• Reviews quality data, conducts audits, tracks quality metrics and reports findings to appropriate management
• Conducts training for OSS Coordinators and OSS Associates
• Monitors incoming calls and emails to ensure issues are addressed and resolved in a timely manner
• Assists leadership to identify and implement process improvement initiatives
• Assists in interviews of Coordinators and Associates and provides feedback to hiring manager

Operations Support Services Specialist

Vice President

• Leads transformation initiatives that support business unit growth objectives and deliver measurable impact through structured execution and strategic alignment.
• Partners with divisional and functional leaders to identify and focus on high-value, enterprise-critical initiatives that advance organizational priorities.
• Designs and delivers transformation programs by coordinating cross-functional teams, ensuring seamless execution and alignment with strategic goals.
• Leads process redesign efforts with an emphasis on data-driven thinking and technology enablement to enhance efficiency and unlock innovation.
• Accelerates deployment of innovative solutions by identifying, prioritizing, and implementing high-impact use cases in collaboration with technology and business leaders.
• Applies analytical rigor to diagnose root causes, solve complex business problems, and inform data-backed decision-making.
• Drives adoption and cultural alignment by executing proactive change management strategies and engaging stakeholders at all levels.
• Serves as a trusted advisor by bringing strategic insight, executive presence, and clear, compelling communication to leadership discussions.
• Tracks outcomes, manages risks, and embeds a culture of continuous improvement into all transformation efforts to ensure long-term success.

Vice President – Business Transformation

Consultant

• Manage claim caseload of highly complex claims
• Handle claims of at least one million dollars
• Establish and maintain effective relationship with internal and external customers
• Mentor and coach account representatives and account specialists
• Investigate, evaluate, and resolve claims
• Review client files and collaborate with team to prepare information
• Proactively manage litigation in conjunction with client requirements