Senior Account Consultant

Sedgwick

. Manage a claim caseload ranging from basic to highly complex claims within granted authority levels .

Posted 11/11/2026full-timeRemote • Texas • United StatesSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in claims management, including the ability to investigate, evaluate, and resolve complex claims while ensuring compliance with jurisdictional requirements. Strong communication and mentoring skills are essential for effective collaboration with internal teams and external clients.

Highest-signal resume keywords

Claims ManagementState Adjuster LicensesLegal and Jurisdictional KnowledgeAnalytical and Interpretive SkillsCustomer Service Skills

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Claims InvestigationFinancial Implications ManagementMedical Report InterpretationIndemnity AssessmentExpense Exposure AnalysisSAS/SOX DocumentationEDI Compliance MonitoringFile Strategy ReviewSubrogation CoordinationFraud Evaluation

Soft Skills

Effective CommunicationMentoring and CoachingOrganizational SkillsInterpersonal SkillsTeam Collaboration

Tools & Technologies

Microsoft Office

Certifications & Qualifications

State Adjuster Licenses

Industry Keywords

Claims Caseload ManagementCompliancePerformance CompetenciesQuality ProgramsLitigation Management

About the role

Key responsibilities & impact

Manage a claim caseload ranging from basic to highly complex claims within granted authority levels
Manage related financial implications of assigned claims
Utilize special account instructions to obtain customer information and adhere to instructions
Identify, initiate, and coordinate specialized services such as subrogation, fraud evaluation, and case management review
Establish and maintain effective relationships with internal and external customers and coworkers
Communicate effectively and timely
Mentor and coach account representatives and account specialists
Facilitate round table discussions within the assigned team
Investigate, evaluate, and resolve claims
Identify potential problems and trends in claim files and take corrective action or make recommendations
Interpret medical reports and state or jurisdictional law in claim handling
Assess indemnity, medical, and expense exposure and apply insurance coverage appropriately
Review client files and collaborate with the team on file strategies, claim status, and emerging trends
Proactively manage litigation with clients and legal representatives
Minimize financial liability and ensure compliance and best possible outcomes
Compile requirements to prevent penalties and fines
Monitor reports and document compliance with jurisdictional requirements, including EDI and benefit-payment timeliness
Assist the Team Lead in tracking team tasks and projects
Review and submit SAS/SOX documents timely
Assist with takeover and reverse takeover projects and ensure appropriate claim-file transfers
Perform other duties as assigned
Support the organization's quality programs

Requirements

What you’ll need

State adjuster licenses required
Six (6) years of related experience and/or training or equivalent combination of education and experience required
Bachelor's degree from an accredited college or university preferred
Thorough legal and jurisdictional knowledge based on line of business
Strong oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Strong customer service skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies

Benefits

Comp & perks

Work-life balance
Caring culture
Career growth opportunities
Reasonable accommodations when applicable and appropriate
Equal opportunity employer
Drug-free workplace