Sedgwick

Claims Specialist

• Responsible for end‑to‑end management of complex property damage claims, from investigation through resolution, ensuring accurate liability assessment and timely outcomes.
• Oversees reserve strategy, settlement negotiations, payments, and statutory filings while maintaining compliance with authority levels and regulatory requirements.
• Manages litigation, vendor partnerships, excess carrier reporting, and recovery efforts to drive cost‑effective claim resolution.
• Serves as a primary point of contact for claimants and clients, maintaining clear communication, strong relationships, and well‑documented claim files.
• Collaborates with leadership to escalate complex matters appropriately and support strategic claim handling decisions.
• Ensures adherence to internal quality standards, regulatory compliance, and best practices while contributing to continuous improvement initiatives.

Claims Examiner – Liability, Property Damage, Licensing: Reciprocal Required, Jurisdiction: Multi State

• Analyzes and processes complex or technically difficult general liability and litigated 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.
• Assesses liability and resolves claims within evaluation.
• Negotiates settlement of claims within designated authority.
• Calculates and assigns timely and appropriate reserves to claims.

Claims Examiner – Liability, GL and Litigation

• 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, GL, Auto, Bodily Injury, Professional Liability

Workers' Compensation Claims Examiner – NY, VT Jurisdictional Knowledge

• Analyzes and processes complex or technically difficult medical malpractice 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.
• Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions.
• Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life.
• Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement.
• Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients.
• Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost.
• Represents Company in depositions, mediations, and trial monitoring as needed.
• Communicates claim activity and processing with 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).

Senior Claims Specialist, Medical Malpractice

Underwriter

• To provide property, liability and/or workers' compensation underwriting and related services to clients and/or marketers within delegated authority.
• Analyzes, rates and approves underwriting referrals in a timely manner according to underwriting authority.
• Liaises with assigned customers and is responsible for timely and professional responses to underwriting/related requests and questions.
• Maintains detailed underwriting records.
• Reviews submissions and referrals with supervisor or designated underwriting referral contact as needed.
• Acts as a liaison with other departments and partners including customers, Sedgwick/Pools, claims, loss control, and accounting departments as well as reinsurers and marketers.
• Assists in analytical and administrative projects as assigned.

Underwriting Analyst – Property and Casualty

• 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.
• Investigate and gather information to determine the exposure on the claim.
• Negotiate settlement of claims within designated authority.
• Communicate claim activity and processing with the claimant and the client.
• Report claims to the excess carrier and respond to requests of directions in a professional and timely manner.

Claims Examiner – Workers Compensation

• To analyze mid- and higher-level workers compensation claims to determine benefits due.
• To ensure ongoing adjudication of claims within company standards and industry best practices.
• To identify subrogation of claims and negotiate settlements.
• Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
• Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.
• 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.
• Ensures claim files are properly documented and claims coding is correct.

Claims Adjuster

Data Scientist

• To develop and manage predictive modeling assignments through completion; to communicate results; to make recommendations to management; and to ensure model ownership, implementation, and monitoring; to spot trends and to gain maximum insight that can give the company a competitive advantage.
• Develops, prepares, and manages predictive models through completion.
• Identifies required resources; researches data, procedures, and history for a thorough understanding of project direction.
• Collects new data and statistics from multiple sources and generates statistical analysis.
• Collaborates with data management team to develop, refine, and scale data management and analytics procedures, systems, workflows, best practices, and other issues.
• Partners with both business and IT leaders to influence how the organization approaches and meets business challenges of an evolving customer base and changing marketplace, using strong business acumen.
• Prepares reports using various system programs and coordinating with other departments.
• Develops and trains the data management team on new or updated procedures as needed.

Compliance

• Creates and maintains relationships with state regulators in order to further company’s reputation and standing with the state(s).
• Maintains working knowledge of state regulatory system and keeps abreast of state regulatory fee schedule changes and enhancements.
• Identifies, develops, and assists in delivery of colleague training on state system compliance issues and enhancements to current systems regarding medical bill review.
• Identifies appropriate bill review system enhancements to improve compliance; requests enhancements as appropriate.
• Works with state workers compensation agencies as appropriate.
• Provides required reporting on claims, penalty and compliance issues to ensure compliance within the state(s).
• Acts as the primary liaison between company and carrier partners on specific issues of penalties within the jurisdiction.
• Assists in delivery of focused jurisdictional compliance training.

Workers Compensation Compliance Specialist

Workers Compensation Claims Examiner – NY Lost-Time Experience, NY Licensing

• To analyze complex or technically difficult medical malpractice claims; to provide resolution of highly complex nature and/or severe injury claims.
• To coordinate case management within Company standards, industry best practices and specific client service requirements.
• To manage the total claim costs while providing high levels of customer service.
• Analyzes and processes complex or technically difficult medical malpractice and long term care claims by investigating and gathering information to determine the exposure on the claim.
• Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions.
• Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life.
• Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement.
• Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients.
• Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost.
• Represents Company in depositions, mediations, and trial monitoring as needed.
• Communicates claim activity and processing with 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.

Senior Claims Specialist – Professional Liability, Long Term Care, Medical Malpractice

• To process low level general liability claims to determine benefits due
• To ensure ongoing adjudication of claims within company standards and industry best practices
• To identify subrogation of claims and negotiate settlements with general supervision
• Processes low level general 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
• Develops and coordinates low level general liability claims' action plans to resolution, return-to-work efforts, and approves claim payments
• Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract
• Performs other duties as assigned
• Supports the organization's quality program(s)
• Travels as required.

Claims Representative – Liability

Platform Engineer

• Manages the technical foundation of Sedgwick’s enterprise web platform
• Ensures that Sedgwick’s web ecosystem remains discoverable, performant, scalable, and resilient
• Leads the technical implementation of SEO and AIO strategy across the platform
• Coordinates with DevOps on CI/CD processes without owning infrastructure or pipelines

Lead Web Platform Engineer

Frontend Engineer

• The Lead Web Front-end Engineer is responsible for building and evolving Sedgwick’s enterprise web content management system with a primary focus on theme architecture, reusable components, accessibility, and performance
• Develops and manages the web content management system theme architecture, block systems, and component library
• Develops and maintains reusable, standards-based components that support campaign landing pages, evergreen content, and international content
• Ensures front-end implementations scale cleanly as content volume increases
• Partners closely with UX/UI designers to bring page designs to life
• Builds front end experiences that meet Core Web Vitals and Lighthouse performance targets
• Optimizes rendering, image handling, script loading, and layout stability
• Ensures compliance with all frontend work meeting WCAG 2.1 AA standards
• Collaborates with Web Producers to ensure components are easy to use, hard to misuse, and consistent with brand and UX standards