Sedgwick

Claims Specialist

• Analyze and process workers compensation claims through action plans toward appropriate and timely resolution
• Investigate and gather information to determine claim exposure
• Negotiate claim settlements within designated authority
• Communicate claim activity and processing with claimants and clients
• Report claims to the excess carrier
• Respond to requests for directions professionally and promptly
• Adjudicate claims within service expectations, industry best practices, and client-specific requirements

Claims Adjuster – Workers Compensation

Claims Assistant

• Set up and enter new claims into the claims management system
• Input and review notes and diaries in the claims management system as instructed
• Process payments
• Process mail and handle filing, faxing, and photocopying
• Review, prepare, create, and/or send letters, reports, and forms
• Answer and initiate telephone calls
• Set up medical appointments
• Provide customer service as required
• Complete assigned activities and projects, including preparing and distributing computer reports
• Perform other assigned duties
• Support the organization's quality programs

Claims Assistant – Workers Compensation

Adjuster

• Investigate and adjust residential and commercial property and casualty claims with little to no supervision
• Inspect claims and contact involved parties in a timely manner
• Investigate claims for coverage determination, cause, compensable damages, and reserves
• Examine insurance policies and records to determine coverage
• Prepare estimates for repair and/or replacement costs
• Interview claimants and witnesses
• Negotiate and settle first- and third-party claims
• Address salvage and subrogation as required by the client
• Maintain client relationships to support repeat business referrals
• Perform other assigned duties
• Support the organization’s quality programs
• Travel as required

Senior Adjuster

Case Coordinator

• Provide excellent customer service and internal support to an assigned team
• Manage workers’ compensation claims caseload under supervision and in collaboration with the Clinical Case Management Team
• Collect and document data for workers’ compensation claims while following workflow and company guidelines
• Process and facilitate necessary treatment services according to company policy and procedure
• Verify return-to-work and remain-at-work status through routine communication with claim parties and documentation in the claim management system
• Use telephonic and written communications to accurately report return-to-work dates
• Maintain knowledge of Bureau of Workers’ Compensation rules and laws, workers’ compensation processes, and Sedgwick policies and procedures

Advisor

• Manage an allocated portfolio of low-complexity claims from notification through resolution and closure
• Assess and progress claims
• Gather, review and maintain information supporting claim assessment and decision-making
• Communicate with customers, clients, brokers, service providers and other stakeholders
• Manage claim payments and other transactions within delegated authority
• Identify and escalate claims requiring additional technical assessment, investigation or authority
• Maintain accurate, complete and current claim records and documentation
• Support Claims Consultants and team members with claims portfolios and operational activities
• Contribute to client service standards, contractual obligations and business performance objectives
• Ensure compliance with legislation, industry codes, client requirements and company policies
• Contribute to team collaboration, knowledge sharing and continuous improvement
• Deliver timely, accurate and customer-focused claim outcomes
• Maintain claim quality, documentation and administrative accuracy
• Meet service standards, client commitments and operational performance objectives

Motor Claims Advisor

• Analyze bodily injury claims on behalf of clients to determine benefits due
• Ensure ongoing adjudication of claims within service expectations, industry best practices, and client service requirements
• Investigate claims and gather information to determine claim exposure
• Process claims through action plans to timely and appropriate resolution
• Negotiate claim settlements within designated authority
• Communicate claim activity and processing with claimants and clients
• Report claims to excess carriers
• Respond professionally and promptly to requests for directions

Claims Examiner – Auto/Bodily Injury

Account Manager

• Oversee technical and operational functions, including compliance with company standards and industry best practices
• Ensure consistent delivery of quality services
• Oversee staffing and training needs
• Oversee budget preparation and profit and loss management
• Oversee the internal quality review process and report monthly
• Assure compliance with client internal controls, audit requirements, and service agreement requirements
• Establish business plans with goals and objectives for assigned clients
• Ensure claims management policies and procedures are followed to meet service standards, state statutes/regulations, disability plan documents, industry best practices, and client service requirements
• Establish and maintain client contacts
• 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 colleague performance discussions
• Provide support, guidance, leadership, and motivation to promote maximum performance
• Perform other duties as assigned
• Travel as required

Senior Account Manager

• Analyze and process auto and general liability property damage claims
• Process claims, assess damage, make payments, and ensure claim files are properly documented and correctly coded based on the policy
• Develop and maintain action plans to meet state-required contract deadlines and move files toward prompt and appropriate resolution
• Identify and pursue subrogation opportunities; secure and dispose of salvage
• Communicate claim action and processing with insureds, clients, and agents or brokers when appropriate
• Maintain professional client relations
• Perform coverage, liability, and damage analysis on all claims assignments
• Support the organization's quality programs
• Perform other duties as assigned
• Travel as required

Claims Representative, Auto

• Analyze and process auto and general liability property damage claims
• Assess damage, make payments, and ensure claim files are properly documented and correctly coded based on the policy
• Develop and maintain action plans to meet state-required contract deadlines and move files toward prompt and appropriate resolution
• Identify and pursue subrogation opportunities
• Secure and dispose of salvage
• Communicate claim action and processing with insureds, clients, and agents or brokers when appropriate
• Maintain professional client relations
• Perform coverage, liability, and damage analysis on all claims assignments
• Support the organization's quality programs
• Perform other duties as assigned
• Travel as required

Claims Representative, Auto – Property Damage

• Attend and complete the designated claims professional training program
• Adjust various levels of workers’ compensation claims under close supervision
• Process and respond to incoming mail, emails, and other claim-related documents
• Communicate with injured workers, insureds/employers, medical providers, attorneys, and carrier representatives through telephone, video conference, and email
• Investigate new and existing claims by gathering medical records, employer reports, and witness statements
• Investigate employer/employee relationships, policy verification, coverage, potential subrogation issues, and fraud indicators
• Determine coverage, compensability, and appropriate benefits according to jurisdictional guidelines and carrier program requirements
• Document claims files and code claim activity
• Prepare detailed reports documenting findings and recommendations
• Administer indemnity and medical benefits while maintaining calendared claim-related action items and state compliance
• Participate in virtual and/or in-person meetings, claim reviews, and business functions for training and claim discussions

IAP Claims Representative – SkillBridge Conversion

Product Manager

• Maintain and prioritize the product backlog to maximize business value
• Translate client needs into clear, actionable requirements
• Solicit stakeholder input and feedback to inform product decisions
• Partner with the development team to balance functional outcomes with technical feasibility
• Manage dependencies and support predictable delivery
• Set product vision and roadmap
• Conduct external and internal discovery to identify client needs, market opportunities, and business priorities
• Collaborate with Operations, Sales, and Product leadership to ensure strategic alignment and secure sign-off on key business decisions
• Define product outcomes and communicate roadmap progress, risks, and dependencies
• Estimate effort and allocate capacity
• Define business and functional requirements and gather necessary inputs
• Define user stories and acceptance criteria and prioritize the backlog
• Communicate product strategy, requirements, and priorities to development teams
• Coordinate intra-team and external dependencies
• Collect, track, and report KPI data
• Represent the development team in core delivery, non-functional requirements, maintenance, support, and technical debt initiatives
• Participate in sprint ceremonies, planning, reviews, and retrospectives
• Author IT and product documentation
• Maintain understanding of business processes and internal system configurations
• Assess business process changes and system impacts
• Serve as primary stakeholder contact
• Provide product expertise and support for release readiness, lifecycle management, and continuous improvement
• Perform other duties as assigned
• Travel as required

• Analyze reported lower-level liability claims to determine benefits due
• Ensure ongoing adjudication of claims within company standards and industry best practices
• Handle lower-level liability and/or physical damage claims under close supervision
• Support claims representatives, examiners, and leads with larger or more complex claims
• Process general liability claims, determining compensability and benefits due
• Monitor reserve accuracy and file necessary documentation with state agency
• Communicate claim action and processing with claimant, client, and appropriate medical contact
• Ensure claim files are properly documented and claims coding is correct
• Process routine payments, prescriptions, and status reports for lifetime medical or defined-period medical claims
• Maintain professional client relationships
• Support the organization's quality programs
• Perform other duties as assigned

Claims Associate – Liability

• Provide excellent customer service and internal support to an assigned team
• Manage workers’ compensation claims caseload under supervision and in collaboration with the Clinical Case Management Team
• Collect and document data for workers’ compensation claims
• Process and facilitate necessary treatment services according to company policy and procedure
• Verify return-to-work and remain-at-work status through communication with claim parties and documentation in the claim management system
• Use telephonic and written communications to accurately report return-to-work dates
• Maintain knowledge of Bureau of Workers’ Compensation rules and laws, workers’ compensation processes, and Sedgwick policies and procedures

Artificial Intelligence

• Own and set the enterprise Generative AI and Agentic AI architecture vision and multi-year roadmap
• Chair or co-lead executive architecture and AI governance forums
• Direct the enterprise intelligence layer strategy, including reference architectures, standards, reusable patterns, and platform capabilities
• Define and govern the enterprise agentic AI strategy and platform blueprint
• Establish enterprise patterns for multi-agent orchestration, reasoning, tool use, memory, human-in-the-loop controls, observability, fail-safes, and lifecycle management
• Set enterprise standards for GenAI and agentic solutions across AWS and Azure
• Own the enterprise Retrieval-Augmented Generation strategy and common frameworks
• Establish standards for knowledge governance, provenance, permissions, lineage, data quality, and approved knowledge sources
• Define integration patterns for legacy platforms and modern cloud services
• Partner with Enterprise Architecture, Infrastructure, and Platform teams on identity, networking, monitoring, disaster recovery, and service management
• Define shared enterprise data architectures, ontologies, governance models, and operating practices with data, analytics, and platform teams
• Establish standards for AI-ready data products, metadata, semantic layers, and data quality thresholds
• Serve as executive technical authority to security, risk, legal, compliance, and audit stakeholders
• Establish practices for model governance, evaluation, red teaming, bias mitigation, explainability, and controls
• Lead the enterprise AI architecture portfolio and prioritize capabilities and investments
• Define success metrics and track value realization
• Partner with Technology and Business leadership to transition AI initiatives into production operations
• Build and develop enterprise AI architecture talent, coach senior architects, and create communities of practice
• Influence platform/tooling decisions, vendor strategy, and ecosystem partnerships
• Represent the organization as a senior AI architecture leader in executive engagements and transformation initiatives
• Perform other duties as assigned
• Travel as required

Principal Architect – Gen AI

• Design, build, and maintain resilient ETL/ELT pipelines ingesting on-premise systems, AWS services, and Azure platforms for Snowflake and downstream AI services
• Develop and maintain feature stores and analytically optimized datasets for machine learning workflows
• Engineer pipelines for generative AI use cases, including extraction, transformation, chunking, and loading of structured and unstructured data into vector databases
• Serve as a Snowflake power user and technical lead, implementing data modeling, Snowpipe automation, and compute and storage optimization
• Execute non-invasive data extraction from legacy systems while preserving system stability
• Design and manage cross-platform workflows using Airflow, AWS Step Functions, and Azure Data Factory
• Partner with IT, database, infrastructure, and security teams to resolve connectivity and access challenges and secure production approval for integrations
• Implement automated data quality, validation, and observability frameworks
• Optimize storage, compute usage, and query performance across Snowflake, AWS, and Azure
• Partner with MLOps, Data Science, and AI teams to translate experimental use cases into scalable, production-ready data solutions
• Perform other duties as assigned

Claims Adjuster – Workers Compensation

Claims Assistant – Workers Compensation

Senior Adjuster

Case Coordinator

Motor Claims Advisor

Claims Examiner – Auto/Bodily Injury

Senior Account Manager

Claims Representative, Auto

Claims Representative, Auto – Property Damage

IAP Claims Representative – SkillBridge Conversion

Product Manager

Claims Associate – Liability

Case Coordinator

Principal Architect – Gen AI

Engineer – Gen AI