Sedgwick

Pharmacist

• Utilize evidence-based tools to evaluate prescribed medications for patient safety and quality standards
• Perform clinical assessments using pharmacy reports and case files
• Assess clients’ psychosocial needs, cultural implications and support systems
• Evaluate patient drug usage and physician prescribing patterns
• Evaluate overuse, underuse and misuse of prescribed medications
• Recommend testing to determine whether drug diversion is present
• Evaluate the need for and recommend alternative treatment
• Send letters to prescribing physicians and refer to physician advisors as necessary
• Negotiate appropriate level and intensity of care using medical and disability duration guidelines
• Negotiate changes in pharmacy plans with providers
• Consult with clients, nursing staff and claims examiners regarding pharmacy issues
• Perform drug utilization reviews through the pharmacy benefit manager or vendor
• Communicate with claims examiners, clients, vendors, supervisors and other parties
• Maintain client privacy and confidentiality and promote client safety and advocacy

RN Pharmacy

Claims Specialist

• Analyze complex or technically difficult California workers' compensation claims to determine benefits due
• Investigate claims and gather information to determine claim exposure
• Manage claims through action plans to timely and appropriate resolution
• Negotiate claim settlements within designated authority
• Calculate and assign timely and appropriate reserves
• Manage reserve adequacy throughout the life of claims
• Calculate and pay benefits due; approve and make timely claim payments and adjustments
• Settle claims within designated authority level
• Prepare necessary state filings within statutory limits
• Manage litigation processes and ensure timely, cost-effective claims resolution
• Report claims to the excess carrier and respond to requests for directions
• Identify claim subrogation and negotiate settlements
• Deliver customer-facing solutions and collaborate with clients and global experts

Workers Compensation Claims Examiner

• Investigate automobile insurance claims on behalf of insurers or third parties
• Gather relevant information related to losses
• Determine coverage and claim validity
• Communicate with insureds and claimants
• Prepare reports and negotiate settlements
• Maintain concise and accurate records in internal computer systems
• Review and interpret policy wording to apply coverage
• Manage billing for assigned files within prescribed timelines
• Maintain excellent working relationships with existing clients
• Participate in ongoing training on industry issues, legislative changes, and trends
• Identify needs and coordinate the assignment of mandates to field claims adjusters
• Perform any other related duties as assigned

Claims Adjuster – Auto

• Analyze and process complex or technically difficult California workers' compensation claims
• Investigate and gather information to determine claim exposure
• Manage claims through action plans to appropriate and timely resolution
• Negotiate claim settlements within designated authority
• Calculate and assign timely and appropriate reserves
• Manage reserve adequacy throughout the life of claims
• Calculate and pay benefits due; approve and make claim payments and adjustments
• Settle claims within designated authority levels
• Prepare necessary state filings within statutory limits
• Manage the litigation process and ensure timely, cost-effective claims resolution
• Report claims to the excess carrier and respond to requests for direction
• Identify subrogation of claims and negotiate settlements

• Analyze low-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 minor lost-time workers compensation claims under close supervision
• Support claims representatives, examiners, and leads with larger or more complex claims
• Process workers compensation claims, determining compensability and benefits due
• Monitor reserve accuracy and file necessary documentation with state agency
• Communicate claim action and processing with claimants, clients, and appropriate medical contacts
• Ensure claim files are properly documented and claims coding is correct
• Process routine payments, prescriptions, and status reports for lifetime or defined-period medical claims as needed
• Maintain professional client relationships
• Support the organization's quality programs
• Perform other duties as assigned

Claims Associate – Workers Compensation

Product Designer

• Transform Sedgwick’s existing digital platforms into intuitive, clickthrough experiences supporting sales and training opportunities
• Build high-fidelity, code-free Axure RP prototypes simulating real product interactions
• Create user-guided software tours with Supademo
• Design and build interactive websites or presentations using no-code tools such as Ceros
• Create reusable widgets, components, templates, and patterns for demo assets
• Edit and prepare video content for software demonstrations and digital demo assets
• Collect, clean, format, and load demo data into Axure prototypes
• Design and simulate complex, data-driven use cases, including multi-step forms, role-based views, state changes, error handling, and conditional branching
• Build adaptive layouts for desktop, tablet, and mobile environments
• Conduct internal reviews and walkthroughs to validate flows and business rules
• Gather feedback and iterate on interactions, content, and visual behaviors
• Partner with product management, presales/sales, and creative/UX teams
• Maintain design libraries, shared assets, and reusable patterns
• Update prototype content as product features, UI design, and workflows evolve
• Document interaction rules, component usage, and demo setup instructions
• Perform other duties as assigned

Junior UX Prototype Specialist

• Analyze and process complex or technically difficult California workers' compensation claims
• Investigate claims and gather information to determine claim exposure
• Manage claims through action plans to timely and appropriate resolution
• Negotiate claim settlements within designated authority
• Calculate and assign timely, appropriate reserves and manage reserve adequacy throughout the claim lifecycle
• Calculate and pay benefits; approve and make timely claim payments and adjustments
• Settle claims within designated authority level
• Prepare necessary state filings within statutory limits
• Manage the litigation process and ensure timely, cost-effective claims resolution
• Report claims to the excess carrier and respond to requests for direction professionally and promptly
• Identify subrogation opportunities and negotiate settlements

Workers Compensation Claims Examiner, CA Jurisdiction

Backend Engineer

• Define and execute the enterprise Power Platform strategy, roadmap, and operating model
• Translate business priorities into delivery plans with measurable outcomes
• Identify and prioritize automation, low-code, data, and AI opportunities
• Advise senior business and technology leaders on platform capabilities, investments, risks, and adoption
• Define solution architecture, integration patterns, security standards, environment strategy, and platform guardrails
• Establish and mature Power Platform governance and Center of Excellence capabilities
• Create reusable frameworks, components, standards, and reference architectures
• Ensure solutions align with enterprise architecture, data, privacy, security, compliance, and application lifecycle management requirements
• Monitor platform health, technical debt, capacity, licensing considerations, and operational risks
• Lead solutions from intake and design through build, testing, deployment, adoption, and support transition
• Drive multiple initiatives, manage dependencies, remove blockers, and maintain delivery momentum
• Provide hands-on technical leadership and support solution design or troubleshooting
• Ensure solutions are practical, scalable, maintainable, and focused on measurable business value
• Build accountability across delivery teams and communicate progress, decisions, risks, and actions
• Mentor architects, developers, analysts, makers, and citizen developers
• Establish practical guidance and promote reusable solutions and disciplined engineering practices
• Partner with business teams to improve adoption and realize expected benefits
• Stay current on Power Platform, Copilot Studio, Microsoft 365, Azure, and relevant AI capabilities
• Perform other duties as assigned and support organizational quality programs
• Travel to client sites as required

Power Platform Architect – AI

General

• Assist customer service representatives by providing claims general information
• Track trends and investigate internal and external client feedback
• Assist in developing corrective/preventative action
• Participate in cross-functional teams
• Assist in gathering and distributing internal/external customer and product surveys
• Direct workflow and workload assignments for the team
• Communicate claims processes with claimants and clients by phone and/or written correspondence
• Inform claimants about required documentation, time frames, payment information, and claim status
• Maintain a quality service culture within the customer service team
• Act as a customer liaison and assist with application-process and service problem resolution
• Maintain professional client relationships
• Enter verbal and written application information meeting customer requirements
• Direct customer calls to the appropriate person
• Contribute to client-driven performance objectives and service standards
• Support the organization's quality program
• Perform other duties as assigned

DRP Service Center Specialist

Adjuster

• Investigate claims against insurance or other companies for personal, casualty, or property loss or damages
• Attempt to effect out-of-court settlements with claimants
• Handle complex losses locally without assistance up to designated authority
• Assist on larger losses, including accounting-based losses such as business interruption and stock
• Examine claim forms and records to determine insurance coverage
• Interview, telephone, or correspond with claimants and witnesses
• Consult police and hospital records
• Inspect property damage to determine the extent of company liability
• Estimate repair, replacement, or compensation costs
• Prepare findings reports and negotiate settlements with claimants
• Recommend litigation by the legal department when settlement cannot be negotiated
• Attend litigation hearings
• Revise case reserves in assigned claims files to cover probable costs
• Assist in preparing loss experience reports to help determine profitability and calculate adequate future rates
• Perform other assigned duties
• Support organizational quality programs
• Travel as required

Senior Adjuster

Team Lead

• Supervise multiple teams of examiners, multiple product line examiners, and/or at least seven technical operations colleagues
• Monitor colleagues' workloads and individual claim activities
• Provide training and technical/jurisdictional direction on claims adjudication reports
• Identify and advise management of trends, problems, issues, and recommended actions
• Inform management of new procedures and continuous process improvement ideas
• Coordinate projects with management
• Compile, review, and analyze management reports and take appropriate action
• Support the organization's quality programs
• Administer company personnel policies and follow staffing standards and training recommendations
• Interview, hire, and establish colleague performance development plans
• Conduct performance discussions and provide leadership, guidance, support, and motivation
• Perform quality reviews on claims in compliance with audit, service contract, and quality standards
• Act as second-level appeal for client and claimant issues and implement final dispositions
• Review reserve amounts on high-cost claims and claims exceeding examiner authority
• Monitor third-party claims and periodically review litigated, serious vocational rehabilitation, questionable, and sensitive claims
• Maintain client contact, promote professional client relationships, make claim-status recommendations, and provide written claim resumes
• Ensure claims files are correctly coded and adequately documented
• Maintain diaries on team claims, including frequent diaries on complex or high-exposure claims

Claims Team Lead – Premises & General Liability

Consultant

• Address and handle high-end cases involving serious injuries, complex coverage scenarios, and legal inquiries or disputes
• Develop strategies to bring cases to satisfactory resolution
• Review and act on reports and forms; respond to inquiries; seek legal opinion and early resolution; communicate resolutions to appropriate parties
• Handle high-end cases with serious injuries and/or complex coverage scenarios
• Respond to decisions, agreements, and/or court orders; create action plans; determine need for examination; gain client authorization
• Identify cases for settlements/redemptions
• Gather and document additional information and coordinate with client designees
• Request legal/private investigations; assign to and coordinate with local counsel; monitor local counsel performance
• Respond to plaintiff's counsel, union, employee, or client requests
• Identify issues and formulate defense strategies
• Establish or adjust accrued liability and approve administrative expenses
• Identify subrogation opportunities and manage the process
• Attend and participate in mediations, trials, arbitrations, or hearings as needed
• Work with partners to effect early return-to-work
• Support the organization's quality programs
• Perform other duties as assigned

Litigation Consultant – Commercial Bodily Injury

Representative

• Provides disability case management and complex claim determinations based on medical documentation and applicable disability plan interpretation
• Determines benefits due and makes timely payments, approvals, and adjustments
• Medically manages disability claims, including comorbidities, concurrent plans, and complex ADA accommodations
• Makes independent claim determinations or recommends denial of claims to the team lead
• Reviews and analyzes complex medical information to determine disability under the applicable plan
• Oversees complex claim facets and utilizes appropriate clinical resources
• Informs claimants of required documentation, time frames, payment information, and claim status
• Communicates with claimants, clients, and providers regarding the claims process and return-to-work expectations
• Coordinates investigations and reviews contested claims
• Evaluates and arranges referrals to outside vendors or physician advisor reviews, surveillance, independent medical evaluations, functional capability evaluations, and related disability activities
• Negotiates return to work with or without accommodations through the claimant’s physician and employer
• Refers cases to team lead and clinical case management for additional review
• Maintains professional client relationships and provides excellent customer service
• Meets organizational quality program minimum requirements
• Performs other duties as assigned

Senior Disability Representative

Communications

• Lead Sedgwick's client communications strategy and ensure messaging is consistent, clear, client-aligned, and brand-reflective
• Translate complex claims, service, and operational information into understandable, relevant, and useful client-facing content
• Own the content calendar and production of client newsletters and recurring communications
• Partner with communications leadership and senior business leaders on client communication needs, priorities, risks, and opportunities
• Plan, develop content for, and execute virtual client events, webinars, briefings, and post-event communications
• Develop event content, speaking materials, presentations, and supporting communications with subject matter experts and senior leaders
• Manage the client services newsroom and coordinate content sourcing, review, and publication across business units
• Establish governance, editorial, approval, and quality standards for newsroom and event content
• Capture the voice of the customer through events, newsletters, surveys, and other touchpoints
• Analyze feedback, attendance, engagement, and content performance to identify trends, needs, opportunities, and gaps
• Translate findings into recommendations shaping communications, events, campaigns, and marketing investment
• Report to leadership on the reach, effectiveness, and business impact of communications and events
• Identify market trends and growth opportunities with Marketing Strategists
• Collaborate with Marketing Strategists, Sales, and Client Services on integrated campaigns, segmentation, messaging, targeting, and content relevance
• Manage moderately complex communications projects across multiple workstreams and stakeholders, budgets, and deadlines
• Build relationships across Global Communications, Marketing, Claims Operations, Client Services, Sales, Legal, and other functions
• Monitor client communication trends in the insurance and third-party administration marketplace
• Advise management on client communications, content governance, event strategy, and client engagement

Client Communications Director

• Conduct standardized ergonomic assessments of workspaces, job tasks, equipment, and office, remote, industrial, and other work environments
• Document ergonomic exposures and recommend practical controls within established guidelines
• Develop, implement, and evaluate ergonomic program strategies
• Collaborate with individuals, committees, and teams to audit existing programs, policies, standards, procedures, risk-reduction strategies, training programs, and vendor applications
• Analyze workplace injury and loss data
• Prepare formal reports and presentations addressing findings
• Provide advice and counseling to reduce workplace injuries and musculoskeletal exposures
• Develop and deliver ergonomic education programs, demonstrations, and job-specific coaching for colleagues, leaders, and clients
• Recommend workstation, equipment, tool, task, and workflow adjustments
• Maintain accurate assessment records, reports, and supporting documentation
• Provide guidance regarding regulatory developments in human factors and ergonomics
• Support the sales team in developing prospective clients
• Participate in local and national activities to advance ergonomic knowledge and influence industry practices

RN Pharmacy

Workers Compensation Claims Examiner

Claims Adjuster – Auto

Workers Compensation Claims Examiner

Claims Associate – Workers Compensation

Junior UX Prototype Specialist

Workers Compensation Claims Examiner, CA Jurisdiction

Power Platform Architect – AI

DRP Service Center Specialist

Senior Adjuster

Claims Team Lead – Premises & General Liability

Litigation Consultant – Commercial Bodily Injury

Senior Disability Representative

Client Communications Director

Ergonomic Specialist