Sedgwick

Representative

• Provide excellent service and display empathy to callers regarding claims for multiple lines of business
• Expedite the claims process and provide detailed claim notes on all calls
• Resolve issues with a one-call/one-person response and direct calls to appropriate escalation paths
• Act as primary liaison with callers from multiple client accounts within a shared services environment
• Assist with questions and solve problems related to claims applications and servicing processes
• Perform claim intake and full-service customer support within regulatory, company, and client requirements
• Educate customers about claim documentation, filing requirements, time frames, payment information, and claim status
• Educate claimants/callers on client requirements and benefit plans
• Accurately enter verbal and written claim information into the appropriate system
• Direct customer calls to appropriate contacts or escalate to Service Center Specialists/management as needed
• Perform other duties as assigned

Care Team Representative, Afternoon & Evening Shifts

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 claim circumstances for coverage determination, cause, compensable damages, and reserves
• Examine insurance policies and other records to determine coverage
• Prepare estimates for repair and/or replacement costs
• Conduct interviews with claimants and witnesses
• Negotiate and settle first- and third-party claims
• Address salvage and subrogation as required by the client
• Maintain client relationships to assure repeated business referrals
• Perform other duties as assigned
• Support the organization's quality programs
• Travel as required

Senior Adjuster

Recruitment

• Oversee staffing activities within a designated region
• Partner with operational management to implement timely, cost-effective initiatives aligned with regional and corporate objectives
• Identify and cultivate sources for experienced and entry-level personnel through networking, colleague referrals, Internet Mining technology, competitor candidate databases, candidate relationship pipeline management, and staffing technology
• Manage the regional recruiting budget through cost-effective advertising and third-party recruiters
• Develop preferred supplier lists and negotiate discounted contract rates with third-party recruiters
• Screen, interview, and test job applicants as required
• Maintain applicant databases using electronic recruiting software
• Provide regional staffing metrics and track colleague retention
• Consult with regional management regarding turnover issues
• Train and mentor hiring managers and Colleague Resource Generalists on electronic recruiting software
• Provide training on system updates, new-user training, behavioral interviewing techniques, candidate assessment tools, and staffing techniques
• Perform other duties as assigned
• Travel as required

Talent Acquisition Specialist

Product Manager

• Partner with Product Managers on backlog refinement and prioritization, sequencing work based on value, dependencies, and capacity
• Define development-ready stories and requirements by breaking down epics and features into user stories, acceptance criteria, and high-level non-functional requirements
• Execute delegated Product Manager responsibilities when PM capacity or capability is limited
• Collaborate with development teams to ensure stories are understood and aligned with business outcomes
• Participate in and support User Acceptance Testing to validate delivered functionality
• Track and report delivery visibility, risks, dependencies, and performance insights to stakeholders
• Partner with Data Scientists, ML Engineers, and MLOps teams to translate AI/ML capabilities into backlog items
• Raise risks, capacity concerns, and reallocation recommendations to Product Managers
• Support sprint ceremonies, product demos, walkthroughs, and stakeholder communications
• Serve as a subject matter resource for solution workflows and capabilities
• Monitor deployed AI features for performance, drift, and user feedback, surfacing retraining or tuning needs as backlog items
• Perform other duties as assigned

Product Owner – AI

Manager

• Work face to face with injured workers and medical providers
• Facilitate advocacy, progressive medical treatment, and timely return-to-work
• Act as a liaison and provide communication between all involved parties
• Manage complex medical conditions, treatment planning, and recovery from illness or injury
• Serve as a 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, service-resource identification, and service facilitation
• Identify appropriate providers and facilities throughout the continuum of services
• Ensure resources are used in a timely and cost-effective manner to obtain optimum value for clients and reimbursement sources
• Travel frequently while maintaining a home-based office

Field Case Manager

Claims Specialist

• Analyze and process complex or technically difficult general liability claims by investigating and gathering information to determine claim exposure
• Manage claims through well-developed action plans to timely and appropriate resolution
• Manage the litigation process and ensure timely, cost-effective claims resolution
• Coordinate vendor referrals for additional investigation and/or litigation management
• Lead team meetings and assign accountability for follow-up items
• Gather compliance and claims processing information for team meetings
• Assist in interviews of adjusters and clerical staff and provide feedback to the hiring manager
• Support the team lead with monthly reviews of adjuster workloads, identify trends, and suggest adjustments
• May supervise up to three direct reports
• Administer company personnel policies and follow staffing standards and training recommendations
• Interview, hire, establish performance development plans, and conduct performance discussions
• Provide support, guidance, leadership, and motivation to promote maximum performance

Claims Examiner – Workers Compensation, FL

Customer Support

• Support and promote Sedgwick’s mission, strategic vision, and value proposition to adjusters and policyholders
• Serve as a key point of contact for adjusters and landlords during insured relocations
• Manage the full lease extension process, including approvals, updated lease terms, timelines, and expectations
• Monitor upcoming lease expirations to prevent service interruptions
• Coordinate and resolve in-stay service requests, including furniture exchanges, add-ons, and maintenance concerns
• Collaborate with landlords, property managers, and vendors on service solutions and extension agreements
• Investigate and resolve property condition, damage, and vendor performance issues
• Maintain financial and operational records, client ledgers, extension costs, move-out coordination, lease terminations, and security deposit reconciliation
• Document communications, updates, and actions in internal systems
• Identify risks, delays, or service failures and escalate appropriately
• Provide high-touch service for VIP or complex claims
• Handle multiple claims while meeting service-level expectations and deadlines
• Support quality programs and perform other assigned duties

Housing Support Specialist

General

• Coordinate customized temporary housing solutions for displaced policyholders
• Support and promote Sedgwick’s mission, strategic vision, and value proposition to adjusters and policyholders
• Serve as a key point of contact for policyholders during relocation
• Qualify housing needs, including lifestyle, household makeup, accessibility needs, pets, and preferred amenities
• Conduct market research using listing platforms, vendor databases, and internal tools
• Collaborate with housing vendors, landlords, and leasing agents to secure short-term rentals
• Negotiate lease terms, maximize policy benefits, and remain within Additional Living Expense guidelines
• Customize housing options based on policy coverage, budget, availability, quality, and insured expectations
• Provide high-touch service throughout policyholders’ stays, resolving issues and supporting lease extensions, furniture adjustments, and service needs
• Draft and review lease agreements and related documents
• Enter and maintain accurate data in housing databases, CRM tools, and internal platforms
• Monitor local rental trends, landlord regulations, and insurance housing best practices
• Handle multiple claims and assignments with professionalism and urgency
• Serve as the point of contact for VIP clientele
• Perform other duties as assigned and support organizational quality programs

Housing Coordinator

• Coordinate customized temporary housing solutions for displaced policyholders
• Support Sedgwick’s mission, strategic vision, and value proposition to adjusters and policyholders
• Serve as a key point of contact for policyholders during relocation
• Qualify housing needs, including lifestyle, household makeup, accessibility, pets, and amenities
• Conduct market research using listing platforms, vendor databases, and internal tools
• Collaborate with housing vendors, landlords, and leasing agents to secure short-term rentals
• Negotiate lease terms, maximize policy benefits, and remain within Additional Living Expense guidelines
• Customize housing options based on policy coverage, budget, availability, quality, and insured expectations
• Provide high-touch service, resolve issues, and support lease extensions, furniture adjustments, and service needs
• Draft and review lease agreements and related documents
• Enter and maintain accurate data in housing databases, CRM tools, and internal platforms
• Monitor local rental trends, landlord regulations, and insurance housing best practices
• Handle multiple claims and assignments with professionalism and urgency
• Serve as point of contact for VIP clientele
• Support organizational quality programs and perform other assigned duties

• Provide exceptional customer support on Sedgwick's primary temporary housing line
• Serve as a working team lead responsible for daily operational oversight, task delegation, workflow management, service-level performance, and frontline leadership
• Support policyholders, adjusters, hotels, and partners with housing-related inquiries
• Handle inbound calls, hotel bookings and extensions, billing-related questions, emails, and administrative functions
• Act as the primary decision-maker during assigned shifts and manage escalations
• Monitor real-time volume, staffing coverage, customer service performance, team participation, queues, workload, and operational metrics
• Answer inbound calls professionally and compassionately
• Provide guidance, direction, coaching, and real-time support to associates
• Enter new housing claims into internal systems and maintain documentation standards
• Monitor email queues, Outlook mailboxes, carrier portals, web portals, and customer service communication channels
• Contact insureds via text and email regarding hotel extensions and housing requests
• Extend hotel stays and book hotels when necessary
• Update the hotel database and retrieve and audit hotel folios for billing accuracy and compliance
• Verify and document customer interactions and claim activity across internal systems
• Manage IVR call flow and routing based on real-time call volume
• Delegate tasks and coordinate staffing coverage, schedules, absences, holidays, and business demands
• Monitor participation, queue adherence, schedule compliance, breaks, workflow execution, and productivity
• Assist with onboarding, training, coaching, mentoring, and team development
• Motivate team members to meet productivity and quality metrics
• Identify operational challenges and implement solutions, escalating issues to leadership when necessary
• Serve as the sole onsite leader during weekend shifts
• Support quality programs and participate in process improvement initiatives

Customer Service Team Lead

• 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 determinations to approve complex disability claims or recommends denial to the team lead
• Reviews and analyzes complex medical information to determine whether claimants are disabled under the disability plan
• Oversees complex claims outside typical guidelines
• Uses appropriate clinical resources in case assessment
• Determines benefits for workers compensation, SSDI, and other disability offsets
• Informs claimants about required documentation, time frames, payment information, and claim status
• Communicates with claimant providers regarding return-to-work expectations
• Ensures compliance with duration control guidelines and plan provisions
• Communicates with claimants and clients throughout the claims process
• Coordinates investigations and reviews contested claims
• Refers claims for vendor services, physician advisor reviews, surveillance, independent medical evaluations, and functional capability evaluations
• Negotiates return to work with or without accommodations through the claimant’s physician and employer
• Refers cases to team lead and clinical case management when appropriate
• Maintains professional client relationships and provides customer service
• Meets quality program minimum requirements
• Performs other duties as assigned

Senior Disability Representative

Bilingual

• Coordinate activities of absence programs for specific clients
• Assist and support the Benefits Program Manager
• Implement customer surveys
• Assist in client training and benefits fairs
• Prepare reports for program administration
• Serve as liaison between the Company, client HR, and employees in managing absence programs
• Coordinate resolution of escalated issues with clients, employees, healthcare providers, and Company operations
• Evaluate absence program results and best practices
• Assess effectiveness of absence plan administration, communication, and documentation
• Assist with management reports and reports assessing financial impact
• Maintain records and files related to absence programs
• Monitor satisfaction with leave and disability administration and recommend changes
• Support continuous performance and process improvement
• Maintain knowledge of legal requirements and best practices
• Update and maintain absence program procedures, compliance requirements, leave audits, employee handbooks, and related documents
• Assist with client communications and benefits fairs
• Assist clients with approvals for Independent Medical Examinations and Functional Capacity Evaluations
• Perform other duties as assigned
• Support organizational quality programs
• Travel as needed

Benefits Liaison – Bilingual, French

• Analyze and process complex or technically difficult general liability claims
• Investigate and gather information to determine claim exposure
• Manage claims through action plans to timely and appropriate resolution
• Assess liability and resolve claims within evaluation
• Negotiate claim settlements within designated authority
• Calculate and assign timely and appropriate reserves and manage reserve adequacy
• Calculate and pay benefits, approve claim payments and adjustments, and settle claims within authority
• Prepare necessary state filings within statutory limits
• Manage litigation processes for timely and cost-effective resolution
• Coordinate vendor referrals for investigation and litigation management
• Apply cost-containment techniques and strategic vendor partnerships
• Manage claim recoveries, including subrogation, Second Injury Fund excess recoveries, and Social Security and Medicare offsets
• Report claims to excess carriers and respond to direction requests
• Communicate claim activity and processing with claimants and clients
• Maintain professional client relationships
• Ensure claim files are documented and claim coding is correct
• Refer cases to supervisors and management as appropriate
• Support quality programs and perform other assigned duties
• Travel as required

Claims Examiner – Liability, IA, TX, or FL Required

• Analyze and process complex bodily injury auto and commercial transportation claims
• Review coverage and complete investigations
• Determine liability and evaluate the scope of damages
• Process complex auto commercial and personal line claims, including bodily injury
• Ensure claim files are properly documented and coded correctly
• Manage the litigation process on litigated claims
• Coordinate vendor management, including independent adjusters assisting claim investigations
• Report large claims to excess carriers
• Develop and maintain action plans to meet state-required contact deadlines and drive prompt resolution
• Identify and pursue subrogation and risk transfer opportunities
• Secure and dispose of salvage
• Communicate claim actions and processing with insureds, clients, and agents or brokers
• Support the organization's quality programs
• Perform other assigned duties

Claims Examiner – Bodily Injury

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

Care Team Representative, Afternoon & Evening Shifts

Senior Adjuster

Talent Acquisition Specialist

Product Owner – AI

Field Case Manager

Claims Examiner – Workers Compensation, FL

Housing Support Specialist

Housing Coordinator

Housing Coordinator

Customer Service Team Lead

Senior Disability Representative

Benefits Liaison – Bilingual, French

Claims Examiner – Liability, IA, TX, or FL Required

Claims Examiner – Bodily Injury

Claims Adjuster – Liability, GL, BI, PD