Sedgwick

Content Marketing Manager

• Examines insurance policies and other records to determine insurance coverage
• Interviews, telephones, and/or corresponds with claimant and witnesses regarding claim
• Consults police and hospital records and inspects property damage to determine extent of company\'s liability and varying methods of investigation according to type of insurance
• Estimates cost of repair, replacement, or compensation
• Prepares report of findings and negotiates settlement with claimant
• Recommends litigation by legal department when settlement cannot be negotiated
• Attends litigation hearings
• Revises case reserves in assigned claims files to cover probable costs
• Assists in preparing loss experience report to help determine profitability and calculates adequate future rates
• Performs other duties as assigned
• Supports the organization\'s quality program(s)
• Travels as required

Contents Adjuster

Manager

• Serve as patient advocate to support, guide and coordinate care for injured workers, families and caregivers
• Assist injured workers in achieving recovery and autonomy through advocacy, communication, education, identification of service resources and service facilitation
• Facilitate progressive medical treatment and timely return-to-work for injured employees
• Act as a liaison and provide communication between injured workers, medical providers, employers, and reimbursement sources
• Identify appropriate providers and facilities and ensure timely, cost-effective use of resources to obtain optimum value
• Maintain a home-based office while performing frequent travel for in-person meetings and case management

Field Case Manager

Insurance

• Analyze mid- and higher-level general 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
• Gather information to determine liability exposure; assign reserve values to claims
• Make claims payments as necessary and settle claims up to designated authority level
• Approve and process assigned claims, determine benefits due, and manage action plan pursuant to the claim or client contract
• Communicate claim action with claimant and client
• Ensure claim files are properly documented and claims coding is correct
• May process complex lifetime medical and/or defined period medical claims including state and physician filings and decisions on appropriate treatments recommended by utilization review
• Maintain professional client relationships

Claims Adjuster – Liability

• Supervise multiple teams of examiners and technical staff for workers' compensation clients
• Monitor colleagues' workloads, provide training, and monitor individual claim activities
• Provide technical/jurisdictional direction to examiner reports on claims adjudication
• Maintain diaries on claims including frequent diaries on complex or high exposure claims
• Identify and advise management of trends, problems, and recommended courses of action
• Coordinate with management on projects and continuous process improvement
• Compile, review and analyze management reports and take appropriate action
• Perform quality review on claims in compliance with audit and service contract requirements
• Act as second level of appeal for client and claimant issues and implement final dispositions
• Review reserve amounts on high cost claims and claims over examiner authority
• Monitor third party, litigated, vocational rehabilitation, questionable and sensitive claims
• Maintain contact with clients and provide written resumes of specific claims as requested
• Assure direct reports are properly licensed in jurisdictions serviced and that files are coded and documented correctly
• Support the organization's quality program(s)
• Administer personnel policies, interview, hire, establish development plans, and conduct performance discussions
• Provide leadership, support, guidance and motivation to promote maximum performance

Claims Manager I, Workers' Compensation

• Partner with the injured worker, employer, and medical providers to create a case management strategy to facilitate medical recovery and a successful return to work through advocacy, communication and coordination of medical services
• Perform initial and ongoing clinical assessment via telephone calls to evaluate the injured worker's injury, medical treatment, psychosocial needs, cultural implications and support systems
• Effectively communicate and build relationships with the claims’ examiner, client, injured worker, attorney and supervisor
• Identify issues related to delayed recovery and/or return to work and problem solve with a creative thinking approach
• Negotiate treatment and disability duration with providers through use of medical and disability duration guidelines, adhering to quality
• Identify opportunities to expedite care for cost containment and timely medical recovery
• Provide recommendations for alternate clinical resources to support claim resolution
• Maintain client's privacy and confidentiality, promote client safety and advocacy; and adhere to ethical, legal, accreditation and regulatory standards

Telephonic Case Manager

• 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
• Manage workers compensation claims determining compensability and benefits due on long term indemnity claims
• Monitor reserve accuracy and file necessary documentation with state agency
• Develop and manage workers compensation claims' action plans to resolution and coordinate return-to-work efforts
• Approve and process assigned claims and claim payments pursuant to the claim or client contract
• Manage subrogation of claims and negotiate settlements
• Communicate claim action with claimant and client and maintain professional client relationships
• Ensure claim files are properly documented and claims coding is correct
• May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review
• Support the organization's quality program(s) and perform other duties as assigned
• Travel as required

Workers Compensation Claims Adjuster

• To analyze Lost-Time Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. Analyze and process claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering 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.

Workers' Compensation Claims Adjuster

• This Field Case Manager will cover the Chicago, Naperville and Schaumburg, IL region and must live in this area.
• Serve as patient advocate to support, guide and coordinate care for injured workers, families and caregivers.
• Assist injured workers in achieving recovery and autonomy through advocacy, communication, education, identification of service resources and service facilitation.
• Identify appropriate providers and facilities throughout the continuum of services while ensuring timely and cost-effective use of resources.
• Maintain a home-based office with frequent travel required.

RN Field Case Manager

• Serve as patient advocate to support, guide and coordinate care for injured workers, families and caregivers as they navigate through the recovery process.
• Assist injured workers in achieving recovery and autonomy through advocacy, communication, education, identification of service resources and service facilitation.
• Identify appropriate providers and facilities throughout the continuum of services, while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the client and the reimbursement source.
• Frequent travel is required; maintain a home-based office in the greater Miami area.

Customer Support

Customer Service Specialist

Administrative Assistant

• Retrieve hotel folios (receipts) from properties for completed and partial stays.
• Audit hotel folios and related claims for billing accuracy, compliance, and documentation.
• Investigate and resolve billing discrepancies with hotels and internal billing teams.
• Support Hotel Coordinators by processing overnight and early-morning hotel extensions and new bookings.
• Conduct claim audits that contribute to internal reporting, compliance, and operational improvement.
• Ensure timely documentation and clear communication within the claim management system.
• Take initiative in identifying process gaps or opportunities for improvement, and implement solutions proactively.
• Serve as a key link in after-hours operations to ensure seamless claim handling and customer service.
• Book Hotel Stays for displaced policyholders to satisfy FNOL requirements

Operations Administrative Assistant

Attorney

• Analyze mid- and higher-level general liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.
• Manage mid-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.
• Assess 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.
• Performs other duties as assigned.
• Supports the organization's quality program(s).
• Travels as required.

Claims Adjuster Liability

• Serves as the central liaison for all housing support inquiries, including lease extensions, renter concerns, and service-related requests.
• Coordinates adjuster and policyholder communications throughout the housing lifecycle.
• Manages service requests and product replacements with third-party vendors (furniture, housewares, etc.).
• Maintains accurate client ledgers and updates for billing and invoicing.
• Oversees all aspects of the move-out process: Initiates and tracks lease extension requests.
• Sends official notices to landlords and policyholders.
• Schedules and confirms vendor pickups for furnishings.
• Coordinates collection and release of security deposits.
• Investigates and resolves damage disputes tied to property or furnishings.
• Proactively identifies, escalates, and supports resolution of urgent or sensitive matters.
• ADDITIONAL FUNCTIONS and RESPONSIBILITIES Performs other duties as assigned.
• Supports the organization's quality program(s).

Housing Support Specialist

Administration

• Serves as the central liaison for all housing support inquiries, including lease extensions, renter concerns, and service-related requests.
• Coordinates adjuster and policyholder communications throughout the housing lifecycle.
• Manages service requests and product replacements with third-party vendors (furniture, housewares, etc.).
• Maintains accurate client ledgers and updates for billing and invoicing.
• Oversees all aspects of the move-out process: Initiates and tracks lease extension requests.
• Sends official notices to landlords and policyholders.
• Schedules and confirms vendor pickups for furnishings.
• Coordinates collection and release of security deposits.
• Investigates and resolves damage disputes tied to property or furnishings.
• Proactively identifies, escalates, and supports resolution of urgent or sensitive matters.

Housing Support Administrator

Medical Director

• Evaluate medical reports and lead clinical reviews for Sedgwick's disability program
• Oversee policy compliance and service delivery in disability management
• Conduct case reviews, communicate with treating physicians, and document recommendations
• Develop training materials and provide leadership to the Client leadership team
• Coordinate with partners and vendors; participate in Independent Medical Review processes
• Provide MRO expertise and occupational health guidance
• Collaborate with other parts of the company as needed

Sr. VP Medical Director

Data Analyst

• We are seeking a motivated and detail-oriented College Fall Intern to join our Operational Excellence team on Data Analytics and Business Intelligence.
• This internship offers a hands-on experience in data visualization, large data processing, and SQL reporting.
• The ideal candidate will have a strong analytical mindset and a passion for turning data into actionable insights.
• Assist in data analysis and the creation of data visualizations to support business decision-making.
• Perform large data crunching and analysis to identify trends and patterns.
• Develop and maintain SQL reports to provide insights to various departments.
• Collaborate with team members to understand data requirements and deliver solutions.
• Participate in team meetings and contribute to project discussions.
• Document processes and methodologies for future reference.
• Hands-on experience with real-world data projects.
• Mentorship and guidance from experienced professionals.
• Opportunity to develop and enhance your technical and analytical skills.
• A collaborative and supportive work environment.
• Potential for future fulltime employment opportunities

Data Analyst Intern

Bilingual

• To negotiate, facilitate and monitor successful return-to-work of claimants within appropriate disability duration guidelines and to assist case management staff with client competence decisions for individual positions.
• Facilitates return-to-work (RTW) and accommodation efforts through negotiation with client, treatment provider and claimant; completes all accommodation/RTW related jurisdictional or client directed documentation, notification, or reporting; and documents client contact in claim notes as per Sedgwick CMS standards.
• Adheres to medical and legal regulations and accreditation standards in written communication.
• Contacts employers to determine specific information regarding employment area (i.e. training/education needed, physical demands, wages and benefits, availability, etc.); ascertains the specific physical tolerances, vocational skills and essential job functions needed for specific employment positions as requested by referral sources or employers; and recommends necessary adaptive equipment as needed.
• Maintains regular contact with clients following placement as per program guidelines, contacts involved individuals regarding progress on each case and makes suggestions as needed for changing plans.
• Works closely with team members to ensure smooth transition from medical case management into job placement.
• Performs other tasks related to accommodation/RTW evaluation and work adjustment as needed.
• ADDITIONAL FUNCTIONS and RESPONSIBILITIES: Performs other duties as assigned.
• QUALIFICATIONS: Education & Licensing HS Diploma/GED required; Bachelor's degree from an accredited college or university preferred.
• Experience: Three (3) years of related experience including one (1) year of return-to-work or job accommodation experience or three (3) years of claims management experience or equivalent combination of education and experience required.
• Skills & Knowledge: Working knowledge of return-to-work or job accommodation procedures; Good technical knowledge of claims management procedures; Excellent oral and written communications, including presentation skills; PC literate, including Microsoft Office products; Analytical and interpretive skills; Strong organizational skills; Excellent interpersonal skills; Excellent negotiation skills; Ability to work in a team environment; Ability to meet or exceed Performance Competencies.
• WORK ENVIRONMENT: Mental : Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
• Physical : Computer keyboarding, travel as required.
• Auditory/Visual : Hearing, vision and talking.

Remote Return to Work Representative, Bilingual Hindi, Bengali, Portuguese

Consultant

• Develops comprehensive, complex and accurate information reports.
• Creates complex data reports and provides analysis for forecasting and/or benchmarking used by senior management.
• Reports directly to senior management; communicates data findings for forecasting and client needs.
• Obtains, analyzes and provides appropriate feedback on company or client specific information needs.
• Provides complex data analysis functions to meet client specific, program or company senior management needs.
• Serves as a resource for colleagues on data analysis and benchmarking issues.
• Provides technical oversight and guidance to client dedicated analysts located in multiple field offices.
• Provides training and data analysis education for colleagues.

Data Consultant

Platform Engineer

• The Power Platform Developer plays a pivotal role in designing, developing, and optimizing intelligent Copilot Agents that enhance productivity, decision-making, and client outcomes across Sedgwick.
• This role combines development expertise with prompt engineering, user experience design, and AI governance to deliver scalable, secure, and impactful agent solutions.
• Designs and builds Copilot Agents using Microsoft Copilot Studio and Power Platform tools.
• Leverages data science techniques (e.g., NLP, classification, clustering) to enhance agent intelligence and contextual awareness.
• Collaborates with business units to translate real-world challenges into agent use cases and prompt flows.
• Develops, tests, and refines prompt templates tailored to diverse operational scenarios.
• Maintains the Sedgwick-specific prompt library and ensures alignment with enterprise standards.
• Ensures agents adhere to data access policies, security protocols, and ethical AI guidelines.
• Supports environment strategy, including role-based access control and publishing workflows.
• Drives improvements through the use of tools like the Copilot Studio Kit to monitor agent usage, performance, and feedback.
• Analyzes telemetry data to identify optimization opportunities and inform future development.
• Partners with IT, business stakeholders, and the broader AI COE to scale agent adoption.
• Partners with product managers, designers, and data scientists to define agent behavior and user experience.
• Provides technical guidance and mentorship to junior developers and citizen creators.
• Performs other duties as assigned.
• Travel as required.

Power Platform Developer

Recruitment

• Oversees staffing activities within a designated region and partners with Operational management to implement timely, cost-effective initiatives aligned with regional and corporate objectives.
• Identifies and cultivates sources for hiring experienced and entry level personnel through: Networking and Colleague Referrals, Development and utilization of Internet Mining technology and capabilities, Development and maintenance of a competitor candidate information database, Development and initiation of a candidate relationship “pipeline management” strategy, Utilization of current and future staffing technology.
• Manages Recruiting budget for region through cost-effective advertisement and third-party recruiters.
• Develops preferred supplier list of third-party recruiters; works with the National Director of staffing to negotiate discounted contract rates for staffing needs.
• Screens, interviews, and tests job applicants as required; maintains applicant database utilizing electronic recruiting software.
• Provides key staffing metrics for regional hiring; tracks regional colleague retention; and consults with regional management regarding issues affecting turnover.
• Trains and mentors hiring managers as well as Colleague Resource Generalists in the use of the electronic recruiting software; builds skill level of regional users by providing training on system updates and new user training.
• Promotes and assists Colleague Resources Managers in training hiring managers in the use of Behavioral Interviewing Techniques, as well as other candidate assessment tools and processes.
• Supports and provides training for the Colleague Resources Generalists in staffing techniques.
• Travels as required.

Talent Acquisition Specialist | Contractor | Hybrid

- Manages mid-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.
- 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.
- May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
- Maintains professional client relationships.
- Travels as required.

Claims Adjuster, Liability, Hybrid

PRIMARY PURPOSE OF THE ROLE: To manage a staff of data analysts; to develop complex reports and analyze company data including Corporate or client specific data; to serve as a technical resource for company staff on data analysis and benchmarking issues; to meet with clients on such issues as necessary; to provide training and data analysis education for program staff; and to provide technical oversight and guidance to client dedicated analysts located in multiple field offices.

Data Analyst Manager

• PRIMARY PURPOSE : 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; and to identify subrogation of claims and negotiate settlements.\n• ESSENTIAL FUNCTIONS and RESPONSIBILITIES Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.\n• Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.\n• Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.\n• Manages subrogation of claims and negotiates settlements.\n• Communicates claim action with claimant and client.\n• Ensures claim files are properly documented and claims coding is correct.\n• May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.\n• Maintains professional client relationships.\n• ADDITIONAL FUNCTIONS and RESPONSIBILITIES\n• Performs other duties as assigned.\n• Supports the organization's quality program(s).\n• Travels as required.\n• QUALIFICATIONS\n• Education & Licensing Bachelor's degree from an accredited college or university preferred.\n• Experience Four (4) years of claims management experience or equivalent combination of education and experience required.\n• Skills & Knowledge Working knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business\n• Excellent oral and written communication, including presentation skills\n• PC literate, including Microsoft Office products\n• Analytical and interpretive skills\n• Strong organizational skill\n• Good interpersonal skills\n• Excellent negotiation skills\n• Ability to work in a team environment\n• Ability to meet or exceed Service Expectations

• Sedgwick Field Case Managers work face to face with their injured workers and medical providers to facilitate advocacy, progressive medical treatment, and timely return-to-work; while acting as a liaison and providing communication between all involved parties.\n• Frequent travel is required; you will maintain a home-based office.\n• Serve as patient advocate to support, guide and coordinate care for injured workers, families and caregivers as they navigate through the recovery process.\n• Assist injured workers in achieving recovery and autonomy through advocacy, communication, education, identification of service resources and service facilitation.\n• Identify appropriate providers and facilities throughout the continuum of services, while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the client and the reimbursement source.\n• Education: RN licensure preferred; or bachelor’s degree in health or human services field required with one of the following certifications: CCM, CDMS, or CRC.\n• Valid driver’s license required. High speed internet required.