Company Detail

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Telephonic Case Manager

This position is a hybrid role that will work remote 3 days per week and 2 days per week in our Baltimore, MD office so much live in this area in order to be considered.

PRIMARY PURPOSE OF THE ROLE: While partnering with the injured worker, employer, and medical providers, create a case management strategy to facilitate medical recovery and a successful return to work through advocacy, communication and coordination of medical services.

ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.

• Apply your medical/clinical or rehabilitation knowledge and experience to assist in the management of complex medical conditions, treatment planning and recovery from illness or injury.

• Work in the best of both worlds - a rewarding career making an impact on the health and lives of others, and a remote work environment.

• Enjoy flexibility and autonomy in your daily work, your location, and your career path while advocating for the most effective and efficient medical treatment for injured employees in a non-traditional setting.

• Enable our Caring countsR mission supporting injured employees from some of the world's best brands and organizations.

• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

• Celebrate your career achievements and each other through professional development opportunities, continuing education credits, team building initiatives and more.

• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Performs 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 communicates and builds relationships with the claims' examiner, client, injured worker, attorney and supervisor.

• Identifies issues related to delayed recovery and/or return to work and problem solves with a creative thinking approach

• Negotiates treatment and disability duration with providers through use of medical and disability duration guidelines, adhering to quality.

• Identifies opportunities to expedite care for cost containment and timely medical recovery.

• Provides recommendations for alternate clinical resources to support claim resolution.

• Maintains client's privacy and confidentiality, promotes client safety and advocacy; and adheres to ethical, legal, accreditation and regulatory standards.

EDUCATION AND LICENSING

Current unrestricted RN license(s) in a state or territory of the United States required. Bachelor's degree in nursing (BSN) from accredited college or university or equivalent work experience preferred. Certification in case management, rehabilitation nursing or a related specialty is highly preferred.

TAKING CARE OF YOU BY

• Offering flexibility and autonomy.

• Supporting meaningful work that promotes critical thinking and problem solving.

• Providing on-going learning and professional growth opportunities.

• Promoting a strong team environment and a culture of support.

• Recognizing your successes and celebrating your achievements.

• Thrives when everyone is working towards the same vision/goals.

• We offer a diverse and comprehensive benefits including medical, dental vision, 401K, PTO and more beginning your first day.

NEXT STEPS

If your application is selected to advance to the next round, recruiter will be in touch.

#nurse #telephoniccasemanager #WCCM #CCM

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Office Assistant - Entry Level - (In-Office)

PRIMARY PURPOSE : To provide administrative support including preparing correspondence and reports, filing, and other general office support activities.

Must reside near Ontario, California for In-Office

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Produces correspondence, reports, and other documentation; files documents, maintains and tracks suspense file, photocopies, sends and receives facsimile transmissions, etc.

• Provides back-up telephone support.

• Processes invoices and billings; maintains records.

• Maintains unit attendance records, library and/or manuals.

• Records meeting minutes.

• Makes travel arrangements.

• Maintains adequate supply inventory; orders supplies as needed.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.

• Supports the organization's quality program(s).

QUALIFICATIONS

Education & Licensing

High school diploma or GED required.

Experience

One (1) year of experience in general office administrative duties or equivalent combination of education and experience required. Experience with an insurance company, broker or consultant preferred.

Skills & Knowledge

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Analytical and interpretive skills

• Strong organizational skills

• Good interpersonal skills

• Ability to work in a team environment

• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental: Clear and conceptual thinking ability; excellent judgment 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

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $15.00 - $17.00 per hour . A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Auto Adjuster

PRIMARY PURPOSE : Handle Auto Bodily Injury and Physical Damage claims.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• 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.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.

• Supports the organization's quality program(s).

• Travels as required.

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred. Obtain IIA-AIC designation within 12 to 18 months. Appropriate state adjuster license is required.

Experience

None.

Skills & Knowledge

• Strong oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Demonstrated commitment to timely reporting

• Strong customer service skills

• Strong interpersonal skills

• Attention to detail and accuracy

• Good time management and organizational skills

• Ability to work independently or in a team environment

• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental : Clear and conceptual thinking ability; excellent judgment and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical :

• Must be able to stand and/or walk for long periods of time.

• Must be able to kneel, squat or bend.

• Must be able to work outdoors in hot and/or cold weather conditions.

• Have the ability to climb, crawl, stoop, kneel, reaching/working overhead

• Be able to lift/carry up to 50 pounds

• Be able to push/pull up to 100 pounds

• Be able to drive up to 4 hours per day.

• Must have continual use of manual dexterity.

Auditory/Visual : Hearing, vision and talking

NOTE : Credit security clearance, confirmed via a background credit check, is required for this position.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Administrative Services Coordinator - CA Team

Our teams connect! This role requires multiple days in office per week.

You must live near either our Dubuque, Iowa office or Dublin, Ohio office

located at:

Dubuque, IA : 4141 Westmark Drive, Dubuque, IA 52002 and

Dublin, OH : 5500 Glendon Court Dublin OH 43016

PRIMARY PURPOSE : To coordinate administrative support functions.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Assigns and directs work and trains new colleagues.

• Coordinates administrative support functions and/or activities.

• Identifies and resolves problems and issues.

• Provides coordination, training and support for unit.

• Provides systems administration and/or technical support for unit specific duties.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.

• Supports the organization's quality program(s).

• Travels as required.

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred.

Experience

Two (2) years of experience in general office administrative duties or equivalent combination of education and experience required.

Skills & Knowledge

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Analytical and interpretive skills

• Strong organizational skills

• Good interpersonal skills

• Ability to work in a team environment

• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

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

NOTE : Credit security clearance, confirmed via a background credit check, is required for this position.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Sr IT Software QA Specialist

PRIMARY PURPOSE : To develop, maintain, test and debug tests for software to meet defined requirements; to formulate and define moderately complex system scope and objectives; to prepare detailed specifications for testing applications; and to design, implement, test, debug, document and maintain test scripts.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Becomes familiar with most aspects of the application including reports, parameters, claims management, intake services, carrier/client interfaces and vendor/business partner interfaces.

• Analyzes user needs as required; assists in design of tests to verify that end user needs have been met.

• Develops and modifies software test scripts and test plans to verify systems meet the specifications outlined in data processing requests; develops and maintains software test script and test plans to verify systems meet requirements of insurance carrier and regulatory groups.

• Tests and verifies assigned projects; assists in testing projects for members of the programming staff.

• Prepares documentation on new or existing software.

• Investigates call escalations from the support staff; makes necessary corrections to data and/or software tests.

• Assists in the professional growth of other quality assurance analysts.

• Follows pre-established standards and guidelines as they pertain to design and development of tests and test plans.

• Maintains up-to-date knowledge of current quality assurance tools and other technology advances.

• Delivers and maintains the highest quality of customer services to our clients.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.

• Supports the organization's quality program(s).

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred. Information Systems or Computer Science major preferred.

Experience

Six (6) years of information technology/computer science experience or equivalent combination of education and experience required to include three (3) years of testing and/or business analytical experience. Experience in interpreting user requirements and development of business application tests strongly preferred.

Skills & Knowledge

• Strong knowledge of software testing and test design

• Good oral and written communication 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

When applicable and appropriate, consideration will be given to reasonable accommodations.

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

NOTE : Credit security clearance, confirmed via a background credit check, is required for this position.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

DRP Service Center Specialist

PRIMARY PURPOSE : To assist customer service representatives in expediting the application by providing claims general information; to track trends; to investigate client feedback both internally and externally; and to assist in developing corrective/preventative action.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Tracks trends, investigates client feedback both internally and externally, and assists in developing corrective/preventative action.

• Participates in cross-functional teams as required.

• Assists in gathering/distribution of internal/external customer/product surveys.

• Directs workflow and workload assignments for the team.

• Communicates claims process with claimant and client either by phone and/or written correspondence.

• Informs claimants of documentation required to process their claim, the required time frames, payment information and claim status either by phone, written correspondence and/or claims system.

• Participates in and maintains a quality service culture within the customer service team.

• Acts as a customer liaison by assisting the customer with problem resolution related to the application process and service; maintains professional client relationships.

• Enters verbal and written application information that meets both the internal and external customers' requirements.

• Directs customer calls to the appropriate person.

• Contributes to achieving client driven performance objectives and other service standards.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.

• Supports the organization's quality program.

QUALIFICATIONS

Education & Licensing

HS diploma or GED required. Associate degree from an accredited college or university preferred.

Experience

Two (2) years call center or customer service experience or equivalent combination of education and experience required.

Skills & Knowledge

• Strong customer service skills

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Strong organizational skills

• Excellent interpersonal skills

• Ability to work in a team environment

• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental: Clear and conceptual thinking ability; excellent judgment 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

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Claims Advisor, Professional Liability

To analyze complex or technically difficult healthcare, environmental, management, executive, cyber, professional liability, error and omissions, and complex liability claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Analyzes and processes complex or technically difficult liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.

• Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions.

• Negotiates claim settlement up to designated authority level.

• Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life.

• Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement.

• Performs coverage analysis and opinion as part of the claim process including all necessary correspondence.

• Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines.

• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients.

• Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost.

• Represents company in depositions, mediations, and trial monitoring as needed.

• Communicates claim activity and processing with the client; maintains professional client relationships.

• Ensures claim files are properly documented and claims coding is correct.

• Refers cases as appropriate to supervisor and management.

• Delegates work and mentors others.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.

• Travels as required.

QUALIFICATIONS

Education & Licensing

Masters or Juris Doctorate degree from an accredited college or university preferred. Licenses as required. Designations and/or licensing including but not limited to Bachelor of Science in Nursing, Legal Nurse Consultant, Associate in Claims (AIC), Chartered Property and Casualty Underwriter (CPCU), Associate in Risk Management (ARM), Associate in Insurance Claims (AIC), Certified Professional in Health Care Risk Management (CPHRM) preferred.

Experience

Ten (10) years of complex claims management experience or equivalent combination of education and experience required.

Skills & Knowledge

• In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as applicable to line-of-business

• Extensive knowledge and comprehension of insurance coverage

• Claims expertise in medical malpractice, errors and omissions, directors and officers, life sciences, and/or cyber liability

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Analytical and interpretive skills

• Strong organizational skills

• Excellent negotiation skills

• Good interpersonal skills

• Ability to work in a team environment

• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

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

NOTE : Credit security clearance, confirmed via a background credit check, is required for this position.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $110,000 . A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Workers Compensation Claims Adjuster | NY Jurisdiction | NY Licensing Required

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?

• Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.

• Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations.

• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

• Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights.

• Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.

• Enjoy flexibility and autonomy in your daily work, your location, and your career path.

• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

PRIMARY PURPOSE OF THE ROLE: To analyze 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.

ESSENTIAL RESPONSIBILITIES MAY INCLUDE

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.

• Negotiating settlement of claims within designated authority.

• Communicating claim activity and processing with the claimant and the client.

• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

QUALIFICATIONS

Education & Licensing: 4+ years of claims management experience or equivalent combination of education and experience required.

• High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.

• Professional certification as applicable to line of business preferred.

Licensing / Jurisdiction Knowledge: NY & NY Licensing

TAKING CARE OF YOU

• Flexible work schedule.

• Referral incentive program.

• Career development and promotional growth opportunities.

• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (70,000 - 80,000). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

#claims #claimsexaminer

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Claims Associate - Workers Compensation | Syracuse, NY

Job Description

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?

• Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.

• Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations.

• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

• Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights.

• Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.

• Enjoy flexibility and autonomy in your daily work, your location, and your career path.

• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

OFFICE LOCATION

Syracuse, NY - Onsite.

PRIMARY PURPOSE OF THE ROLE: To analyze low-level 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.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.

• Negotiating settlement of claims within designated authority.

• Communicating claim activity and processing with the claimant and the client.

• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

QUALIFICATIONS

Education & Licensing: 2+ years of claims management experience or equivalent combination of education and experience required.

• High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.

• Professional certification as applicable to line of business preferred.

Licensing / Jurisdiction Knowledge: Active NY license preferred. If not already obtained, will be required to do so post-hire.

TAKING CARE OF YOU

• Flexible work schedule.

• Referral incentive program.

• Career development and promotional growth opportunities.

• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ( 17.17 - 24.03/hr) A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

#claimsexaminer #claims

at any time.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Claims Team Lead - Liability (Hybrid Schedule in Charlotte, Memphis, Atlanta or Orlando)

PRIMARY PURPOSE : To supervise the operation of multiple teams of examiners and technical staff for liability claims for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Supervises multiple teams of examiners, multiple product line examiners and/or several (minimum seven) technical operations colleagues for a wide span of control; may delegate some duties to others within the unit.

• Identifies and advises management of trends, problems, and issues as well as recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the office.

• Provides technical/jurisdictional direction to examiner reports on claims adjudication.

• Compiles reviews and analyzes management reports and takes appropriate action.

• Performs quality review on claims in compliance with audit requirements, service contract requirements, and quality standards.

• Acts as second level of appeal for client and claimant issues regarding claim specific, procedural or special requests; implements final disposition of the appeal.

• Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner.

• Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client.

• Maintains contact with the client on claims and promotes a professional client relationship; makes recommendations to client as suggested by the claim status; and provides written resumes of specific claims as requested by client.

• Assures that direct reports are properly licensed in the jurisdictions serviced.

• Ensures claims files are coded correctly and adequate documentation is made by claims examiners.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.

• Supports the organization's quality program(s).

SUPERVISORY RESPONSIBILITIES

• Administers company personnel policies in all areas and follows company staffing standards and training recommendations.

• Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.

• Provides support, guidance, leadership and motivation to promote maximum performance.

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certifications as applicable to line of business preferred.

Experience

Six (6) years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.

Skills & Knowledge

• Thorough knowledge of claims management processes and procedures for multiple product lines

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Leadership/management/motivational skills

• 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

When applicable and appropriate, consideration will be given to reasonable accommodations.

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

NOTE : Credit security clearance, confirmed via a background credit check, is required for this position.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Workers Compensation Claims Adjuster

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.

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.

• Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.

• 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.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.

• Supports the organization's quality program(s).

• Travels as required.

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred.

Experience

Four (4) years of claims management experience or equivalent combination of education and experience required.

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

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Analytical and interpretive skills

• Strong organizational skill

• Good interpersonal skills

• Excellent negotiation skills

• Ability to work in a team environment

• Ability to meet or exceed Service Expectations

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

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

NOTE : Credit security clearance, confirmed via a background credit check, is required for this position.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (53,000 - 74,000). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Claims Adjuster - Workers Compensation - (Hybrid Schedule)

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.

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.

• Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.

• 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.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.

• Supports the organization's quality program(s).

• Travels as required.

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred.

Experience

Four (4) years of claims management experience or equivalent combination of education and experience required.

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

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Analytical and interpretive skills

• Strong organizational skill

• Good interpersonal skills

• Excellent negotiation skills

• Ability to work in a team environment

• Ability to meet or exceed Service Expectations

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

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

NOTE : Credit security clearance, confirmed via a background credit check, is required for this position.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $70,000 - $95,000 per year . A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

#LI-DV1

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Claims Team Lead - Workers Compensation - (Hybrid Schedule)

PRIMARY PURPOSE: To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Supervises multiple teams of examiners, multiple product line examiners and/or several (minimum seven) technical operations colleagues for a wide span of control; may delegate some duties to others within the unit.

• Identifies and advises management of trends, problems, and issues as well as recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the office.

• Provides technical/jurisdictional direction to examiner reports on claims adjudication.

• Compiles reviews and analyzes management reports and takes appropriate action.

• Performs quality review on claims in compliance with audit requirements, service contract requirements, and quality standards.

• Acts as second level of appeal for client and claimant issues regarding claim specific, procedural or special requests; implements final disposition of the appeal.

• Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner.

• Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client.

• Maintains contact with the client on claims and promotes a professional client relationship; makes recommendations to client as suggested by the claim status; and provides written resumes of specific claims as requested by client.

• Assures that direct reports are properly licensed in the jurisdictions serviced.

• Ensures claims files are coded correctly and adequate documentation is made by claims examiners.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.

• Supports the organization's quality program(s).

SUPERVISORY RESPONSIBILITIES

• Administers company personnel policies in all areas and follows company staffing standards and training recommendations.

• Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.

• Provides support, guidance, leadership and motivation to promote maximum performance.

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certifications as applicable to line of business preferred.

Experience

Six (6) years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.

Skills & Knowledge

• Thorough knowledge of claims management processes and procedures for multiple product lines

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Leadership/management/motivational skills

• 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

When applicable and appropriate, consideration will be given to reasonable accommodations.

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

NOTE : Credit security clearance, confirmed via a background credit check, is required for this position.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $100,000 - $110,000 per year . A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

#LI-DV1

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Telephonic Case Manager

This position is a hybrid role that will work remote 3 days per week and 2 days per week in our Baltimore, MD office so much live in this area in order to be considered.

PRIMARY PURPOSE OF THE ROLE: While partnering with the injured worker, employer, and medical providers, create a case management strategy to facilitate medical recovery and a successful return to work through advocacy, communication and coordination of medical services.

ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.

• Apply your medical/clinical or rehabilitation knowledge and experience to assist in the management of complex medical conditions, treatment planning and recovery from illness or injury.

• Work in the best of both worlds - a rewarding career making an impact on the health and lives of others, and a remote work environment.

• Enjoy flexibility and autonomy in your daily work, your location, and your career path while advocating for the most effective and efficient medical treatment for injured employees in a non-traditional setting.

• Enable our Caring countsR mission supporting injured employees from some of the world's best brands and organizations.

• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

• Celebrate your career achievements and each other through professional development opportunities, continuing education credits, team building initiatives and more.

• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Performs 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 communicates and builds relationships with the claims' examiner, client, injured worker, attorney and supervisor.

• Identifies issues related to delayed recovery and/or return to work and problem solves with a creative thinking approach

• Negotiates treatment and disability duration with providers through use of medical and disability duration guidelines, adhering to quality.

• Identifies opportunities to expedite care for cost containment and timely medical recovery.

• Provides recommendations for alternate clinical resources to support claim resolution.

• Maintains client's privacy and confidentiality, promotes client safety and advocacy; and adheres to ethical, legal, accreditation and regulatory standards.

EDUCATION AND LICENSING

Current unrestricted RN license(s) in a state or territory of the United States required. Bachelor's degree in nursing (BSN) from accredited college or university or equivalent work experience preferred. Certification in case management, rehabilitation nursing or a related specialty is highly preferred.

TAKING CARE OF YOU BY

• Offering flexibility and autonomy.

• Supporting meaningful work that promotes critical thinking and problem solving.

• Providing on-going learning and professional growth opportunities.

• Promoting a strong team environment and a culture of support.

• Recognizing your successes and celebrating your achievements.

• Thrives when everyone is working towards the same vision/goals.

• We offer a diverse and comprehensive benefits including medical, dental vision, 401K, PTO and more beginning your first day.

NEXT STEPS

If your application is selected to advance to the next round, recruiter will be in touch.

#nurse #telephoniccasemanager #WCCM #CCM

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Claims Adjuster - Workers Compensation | NY License

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?

• Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.

• Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations.

• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

• Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights.

• Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.

• Enjoy flexibility and autonomy in your daily work, your location, and your career path.

• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

PREFERRED GEOGRAPHIC LOCATIONS

Northeast Region - Remote

Candidates outside of the preferred geographic regions listed above may still be considered based on level of experience.

PRIMARY PURPOSE OF THE ROLE: To analyze high-level 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.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.

• Negotiating settlement of claims within designated authority.

• Communicating claim activity and processing with the claimant and the client.

• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

QUALIFICATIONS

Education & Licensing: 4+ years of claims management experience or equivalent combination of education and experience required.

• High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.

• Professional certification as applicable to line of business preferred.

Licensing / Jurisdiction Knowledge: Active NY Adjusters License required.

TAKING CARE OF YOU

• Flexible work schedule.

• Referral incentive program.

• Career development and promotional growth opportunities.

• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ( 55,430.00 - 77,602.00 ). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

#claimsexaminer #claims

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Disability Representative Sr.

PRIMARY PURPOSE : Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation including determining benefits due and making timely payments/approvals and adjustments, medically managing disability claims including comorbidities, concurrent plans, and complex ADA accommodations; coordinates investigative efforts, thoroughly reviews contested claims, negotiates return to work with or without job accommodations, and evaluates and arranges appropriate referral of claims to outside vendors.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Makes independent claim determinations, based on the information received, to approve complex disability claims or makes a recommendation to team lead to deny claims based on the disability plan.

• Reviews and analyzes complex medical information (i.e. attending physician statements, office notes, operative reports, etc.) to determine if the claimant is disabled as defined by the disability plan.

• Oversees additional facets of complex claims including but not limited to comorbidities, concurrent plans, complex ADA accommodations, and claims outside of typical guidelines.

• Utilizes the appropriate clinical resources in case assessment (i.e. duration guidelines, in-house clinicians), as needed.

• Determines benefits due pursuant to a disability plan, makes timely claims payments/approvals and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets.

• Informs claimants of documentation required to process claims, required time frames, payment information and claims status by phone, written correspondence and/or claims system.

• Communicates with the claimants' providers to set expectations regarding return to work.

• Medically manages complex disability claims ensuring compliance with duration control guidelines and plan provisions.

• Communicates clearly and timely with claimant and client on all aspects of claims process by phone, written correspondence and/or claims system.

• Coordinates investigative efforts ensuring appropriateness; provides thorough review of contested claims.

• Evaluates and arranges appropriate referral of claims to outside vendors or physician advisor reviews, surveillance, independent medical evaluation, functional capability evaluation, and/or related disability activities.

• Negotiates return to work with or without job accommodations via the claimant's physician and employer.

• Refers cases to team lead and clinical case management for additional review when appropriate.

• Maintains professional client relationships and provides excellent customer service.

• Meets the organization's quality program(s) minimum requirements.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.

QUALIFICATIONS

Education & Licensing

High School diploma or GED required. Bachelor's degree from an accredited university or college preferred.

Experience

Three (3) years of benefits or disability case/claims management experience or equivalent combination of education and experience preferred.

Skills & Knowledge

• Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management practices and Social Security application procedures

• Knowledge of state and federal FMLA regulations

• Working knowledge of medical terminology and duration management

• Excellent oral and written communication, including presentation skills

• Proficient computer skills including working knowledge of Microsoft Office

• Analytical, interpretive, and critical thinking skills

• Ability to manage ambiguity

• Strong organizational and multitasking skills

• Ability to work in a team environment

• Ability to meet or exceed performance competencies as required by program

• Effective decision-making and negotiation skills

• Ability to exercise judgement autonomously within established procedures

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

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 : Ability to sit at a desk for extended periods while operating a computer and phone system. Travel as required.

Auditory/Visual : Hearing, vision and talking

NOTE : Credit security clearance, confirmed via a background credit check, is required for this position.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $17.61-23.00 per hour. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Contract Manager II

PRIMARY PURPOSE : To negotiate fee-for-service hospital and medical group contracts for multiple lines of business in managed care markets; to maintain provider participation within the network; and to expand and develop provider network.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Negotiates fee-for-service hospital and medical group contracts for multiple lines of business in the managed care markets.

• Analyzes market data and financial models.

• Prepares, negotiates, and administers provider contracts.

• Develops and expands provider participation within the network.

• Maintains provider participation within the network.

• Monitors provider performance; implements corrective action plans.

• Identifies current issues and probable future issues; guides staff through resolution.

• Documents contracts; updates contracts as changes occur.

• Coordinates customer inquiries.

QUALIFICATIONS

• Performs other duties as assigned.

• Supports the organization's quality program(s).

Education & Licensing

Bachelor's degree with major in Health Services or Hospital Administration from an accredited college or university preferred.

Experience

Four (4) years of progressive provider network contract negotiation experience or equivalent combination of education and experience required. Experience in a healthcare management environment including provider contracting, servicing and benefit interpretation preferred. Two (2) years supervisory experience preferred.

Skills & Knowledge

• Strong project management skills

• Excellent negotiation skills

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Leadership/management/motivational skills

• Analytical and interpretive skills

• Strong organizational skills

• Ability to work in a team environment

• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

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

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ( $45,790 - $62,000) . A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Integration Support Specialist

PRIMARY PURPOSE : To lead the analysis efforts for bill review technology and claims management processes supporting operations; to review, analyze and document internal and client user needs; and to ensure alignment of software and related business processes to strategic goals of operations.

The ideal candidate will have bill review industry experience. The primary role is an integration support analyst; however, additional functions and responsibilities include troubleshooting and production support for reported operational and system issues.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Leads the requirements management efforts for large projects; devises and executes a requirements management plan for assigned projects; and takes ownership of the bill review business analysis role throughout the project.

• Works with project managers, project requestors, operations, business representatives, IT representatives and clients to ensure complete understanding of software requirements; reviews software requirements work of other team members to ensure alignment to requirements management governances for the requirements management discipline.

• Produces project requirements documentation including written documents, process diagrams, report mock-ups, wire frames and other documentation as required, using standard templates.

• Provides business related IT knowledge to clients and business representatives during the requirements management process.

• Completes client data conversions by working with vendors within expected timeframes set by Implementation.

• Prepares reports using various system programs and coordinating with other departments.

• Maintains and verifies client parameters in the bill review system and researches issues to resolution.

• Ensures the process/procedural changes are developed and communicated to field offices, IT, Client Services and other applicable business units in regard to regulatory requirements and changes.

• Assists in delivery of focused training.

• Works with Product Manager in monitoring field performance and determining priority of system enhancements.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.

• Supports the organization's quality program(s).

• Travels as required.

QUALIFICATION

Education & Licensing

Bachelor's degree from an accredited college or university preferred.

Experience

Six (6) years of related experience or equivalent combination of education and experience required. Experience in medical bill review processes and system requirements strongly preferred.

Skills & Knowledge

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Analytical and interpretive skills

• Strong organizational skills

• Good interpersonal skills

• Excellent negotiation skills

• Self motivated

• Ability and willingness to take initiative

• Ability to work in a team environment

• Ability to meet or exceed Service Expectations

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

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

NOTE :

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ( $65,000 - $67,000) . A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Integration Support Specialist

PRIMARY PURPOSE : To lead the analysis efforts for bill review technology and claims management processes supporting operations; to review, analyze and document internal and client user needs; and to ensure alignment of software and related business processes to strategic goals of operations.

The ideal candidate will have bill review industry experience. The primary role is an integration support analyst; however, additional functions and responsibilities include troubleshooting and production support for reported operational and system issues.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Leads the requirements management efforts for large projects; devises and executes a requirements management plan for assigned projects; and takes ownership of the bill review business analysis role throughout the project.

• Works with project managers, project requestors, operations, business representatives, IT representatives and clients to ensure complete understanding of software requirements; reviews software requirements work of other team members to ensure alignment to requirements management governances for the requirements management discipline.

• Produces project requirements documentation including written documents, process diagrams, report mock-ups, wire frames and other documentation as required, using standard templates.

• Provides business related IT knowledge to clients and business representatives during the requirements management process.

• Completes client data conversions by working with vendors within expected timeframes set by Implementation.

• Prepares reports using various system programs and coordinating with other departments.

• Maintains and verifies client parameters in the bill review system and researches issues to resolution.

• Ensures the process/procedural changes are developed and communicated to field offices, IT, Client Services and other applicable business units in regard to regulatory requirements and changes.

• Assists in delivery of focused training.

• Works with Product Manager in monitoring field performance and determining priority of system enhancements.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.

• Supports the organization's quality program(s).

• Travels as required.

QUALIFICATION

Education & Licensing

Bachelor's degree from an accredited college or university preferred.

Experience

Six (6) years of related experience or equivalent combination of education and experience required. Experience in medical bill review processes and system requirements strongly preferred.

Skills & Knowledge

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Analytical and interpretive skills

• Strong organizational skills

• Good interpersonal skills

• Excellent negotiation skills

• Self motivated

• Ability and willingness to take initiative

• Ability to work in a team environment

• Ability to meet or exceed Service Expectations

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

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

NOTE :

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ( $65,000 - $67,000) . A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Contract Manager II

PRIMARY PURPOSE : To negotiate fee-for-service hospital and medical group contracts for multiple lines of business in managed care markets; to maintain provider participation within the network; and to expand and develop provider network.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Negotiates fee-for-service hospital and medical group contracts for multiple lines of business in the managed care markets.

• Analyzes market data and financial models.

• Prepares, negotiates, and administers provider contracts.

• Develops and expands provider participation within the network.

• Maintains provider participation within the network.

• Monitors provider performance; implements corrective action plans.

• Identifies current issues and probable future issues; guides staff through resolution.

• Documents contracts; updates contracts as changes occur.

• Coordinates customer inquiries.

QUALIFICATIONS

• Performs other duties as assigned.

• Supports the organization's quality program(s).

Education & Licensing

Bachelor's degree with major in Health Services or Hospital Administration from an accredited college or university preferred.

Experience

Four (4) years of progressive provider network contract negotiation experience or equivalent combination of education and experience required. Experience in a healthcare management environment including provider contracting, servicing and benefit interpretation preferred. Two (2) years supervisory experience preferred.

Skills & Knowledge

• Strong project management skills

• Excellent negotiation skills

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Leadership/management/motivational skills

• Analytical and interpretive skills

• Strong organizational skills

• Ability to work in a team environment

• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

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

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ( $45,790 - $62,000) . A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Contract Manager II

PRIMARY PURPOSE : To negotiate fee-for-service hospital and medical group contracts for multiple lines of business in managed care markets; to maintain provider participation within the network; and to expand and develop provider network.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Negotiates fee-for-service hospital and medical group contracts for multiple lines of business in the managed care markets.

• Analyzes market data and financial models.

• Prepares, negotiates, and administers provider contracts.

• Develops and expands provider participation within the network.

• Maintains provider participation within the network.

• Monitors provider performance; implements corrective action plans.

• Identifies current issues and probable future issues; guides staff through resolution.

• Documents contracts; updates contracts as changes occur.

• Coordinates customer inquiries.

QUALIFICATIONS

• Performs other duties as assigned.

• Supports the organization's quality program(s).

Education & Licensing

Bachelor's degree with major in Health Services or Hospital Administration from an accredited college or university preferred.

Experience

Four (4) years of progressive provider network contract negotiation experience or equivalent combination of education and experience required. Experience in a healthcare management environment including provider contracting, servicing and benefit interpretation preferred. Two (2) years supervisory experience preferred.

Skills & Knowledge

• Strong project management skills

• Excellent negotiation skills

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Leadership/management/motivational skills

• Analytical and interpretive skills

• Strong organizational skills

• Ability to work in a team environment

• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

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

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ( $45,790 - $62,000) . A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Integration Support Specialist

PRIMARY PURPOSE : To lead the analysis efforts for bill review technology and claims management processes supporting operations; to review, analyze and document internal and client user needs; and to ensure alignment of software and related business processes to strategic goals of operations.

The ideal candidate will have bill review industry experience. The primary role is an integration support analyst; however, additional functions and responsibilities include troubleshooting and production support for reported operational and system issues.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Leads the requirements management efforts for large projects; devises and executes a requirements management plan for assigned projects; and takes ownership of the bill review business analysis role throughout the project.

• Works with project managers, project requestors, operations, business representatives, IT representatives and clients to ensure complete understanding of software requirements; reviews software requirements work of other team members to ensure alignment to requirements management governances for the requirements management discipline.

• Produces project requirements documentation including written documents, process diagrams, report mock-ups, wire frames and other documentation as required, using standard templates.

• Provides business related IT knowledge to clients and business representatives during the requirements management process.

• Completes client data conversions by working with vendors within expected timeframes set by Implementation.

• Prepares reports using various system programs and coordinating with other departments.

• Maintains and verifies client parameters in the bill review system and researches issues to resolution.

• Ensures the process/procedural changes are developed and communicated to field offices, IT, Client Services and other applicable business units in regard to regulatory requirements and changes.

• Assists in delivery of focused training.

• Works with Product Manager in monitoring field performance and determining priority of system enhancements.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.

• Supports the organization's quality program(s).

• Travels as required.

QUALIFICATION

Education & Licensing

Bachelor's degree from an accredited college or university preferred.

Experience

Six (6) years of related experience or equivalent combination of education and experience required. Experience in medical bill review processes and system requirements strongly preferred.

Skills & Knowledge

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Analytical and interpretive skills

• Strong organizational skills

• Good interpersonal skills

• Excellent negotiation skills

• Self motivated

• Ability and willingness to take initiative

• Ability to work in a team environment

• Ability to meet or exceed Service Expectations

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

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

NOTE :

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ( $65,000 - $67,000) . A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Contract Manager II

PRIMARY PURPOSE : To negotiate fee-for-service hospital and medical group contracts for multiple lines of business in managed care markets; to maintain provider participation within the network; and to expand and develop provider network.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Negotiates fee-for-service hospital and medical group contracts for multiple lines of business in the managed care markets.

• Analyzes market data and financial models.

• Prepares, negotiates, and administers provider contracts.

• Develops and expands provider participation within the network.

• Maintains provider participation within the network.

• Monitors provider performance; implements corrective action plans.

• Identifies current issues and probable future issues; guides staff through resolution.

• Documents contracts; updates contracts as changes occur.

• Coordinates customer inquiries.

QUALIFICATIONS

• Performs other duties as assigned.

• Supports the organization's quality program(s).

Education & Licensing

Bachelor's degree with major in Health Services or Hospital Administration from an accredited college or university preferred.

Experience

Four (4) years of progressive provider network contract negotiation experience or equivalent combination of education and experience required. Experience in a healthcare management environment including provider contracting, servicing and benefit interpretation preferred. Two (2) years supervisory experience preferred.

Skills & Knowledge

• Strong project management skills

• Excellent negotiation skills

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Leadership/management/motivational skills

• Analytical and interpretive skills

• Strong organizational skills

• Ability to work in a team environment

• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

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

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ( $45,790 - $62,000) . A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

(Hybrid) Litigation Consultant - General Liability | Greater Minneapolis Area

PRIMARY PURPOSE : To address and handle high end cases with serious injuries, complex coverage scenarios and legal inquiries or disputes; to develop a strategy to bring a case to satisfactory resolution.

OFFICE LOCATION

Richfield, MN

M&F - Work from Home

Tues-Thurs - Onsite in Office

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Reviews/acts on reports/forms; responds to inquiries; seeks legal opinion and early resolution; and communicates resolution to appropriate parties.

• Handles high end cases with serious injuries and/or complex coverage scenarios.

• Responds to decisions, agreement, and/or court order; creates action plan; determines need for examination; gains client authorization.

• Identifies cases for settlements/redemptions.

• Gathers/documents additional information and coordinates with client designees.

• Requests legal/private investigation; assigns to and coordinates with local counsel; monitors local counsel performance.

• Responds to plaintiff's counsel, union, employee, or client requests.

• Identifies issues and formulates defense strategy.

• Establishes/adjusts accrued liability and approves administrative expenses.

• Identifies subrogation opportunities and manages process.

• Attends and participates in mediations, trials, arbitrations or hearings as needed.

• Works with partners to affect early return-to-work.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.

• Supports the organization's quality program(s).

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred. Juris Doctorate (JD) preferred.

Experience

Ten (10) years of experience handling litigation including 5 years of claims management experience or equivalent combination of education and experience required.

Skills & Knowledge

• Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.

• Technically skilled and familiar with legal pleadings, discovery et al

• Excellent oral and written communication, 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

#claimsexaminer #claims #LI-DV1

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick

Job Description

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to WorkR

Most Loved WorkplaceR

Forbes Best-in-State Employer

Integration Support Specialist

PRIMARY PURPOSE : To lead the analysis efforts for bill review technology and claims management processes supporting operations; to review, analyze and document internal and client user needs; and to ensure alignment of software and related business processes to strategic goals of operations.

The ideal candidate will have bill review industry experience. The primary role is an integration support analyst; however, additional functions and responsibilities include troubleshooting and production support for reported operational and system issues.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Leads the requirements management efforts for large projects; devises and executes a requirements management plan for assigned projects; and takes ownership of the bill review business analysis role throughout the project.

• Works with project managers, project requestors, operations, business representatives, IT representatives and clients to ensure complete understanding of software requirements; reviews software requirements work of other team members to ensure alignment to requirements management governances for the requirements management discipline.

• Produces project requirements documentation including written documents, process diagrams, report mock-ups, wire frames and other documentation as required, using standard templates.

• Provides business related IT knowledge to clients and business representatives during the requirements management process.

• Completes client data conversions by working with vendors within expected timeframes set by Implementation.

• Prepares reports using various system programs and coordinating with other departments.

• Maintains and verifies client parameters in the bill review system and researches issues to resolution.

• Ensures the process/procedural changes are developed and communicated to field offices, IT, Client Services and other applicable business units in regard to regulatory requirements and changes.

• Assists in delivery of focused training.

• Works with Product Manager in monitoring field performance and determining priority of system enhancements.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.

• Supports the organization's quality program(s).

• Travels as required.

QUALIFICATION

Education & Licensing

Bachelor's degree from an accredited college or university preferred.

Experience

Six (6) years of related experience or equivalent combination of education and experience required. Experience in medical bill review processes and system requirements strongly preferred.

Skills & Knowledge

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Analytical and interpretive skills

• Strong organizational skills

• Good interpersonal skills

• Excellent negotiation skills

• Self motivated

• Ability and willingness to take initiative

• Ability to work in a team environment

• Ability to meet or exceed Service Expectations

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

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

NOTE :

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ( $65,000 - $67,000) . A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Taking care of people is at the heart of everything we do. Caring counts

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Job Detail

• Company:
  Sedgwick