Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 27, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 26, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
Posted - Sep 26, 2024
Taking care of people is at the heart of everything we do, and we start by...
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 experi...
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
Care Team Representative
Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:
Dubuque, IA : 4141 Westmark Drive, Dubuque, IA 52002
Cedar Rapids, IA : 333 1st Street SE Ste. 200 Cedar Rapids IA 52401
Coralville, IA: 3273 Ridgeway Drive Coralville IA 52241
Dublin, OH : 5500 Glendon Court Dublin OH 43016
New Albany, OH : 7795 Walton Parkway New Albany, OH 43054
Indianapolis, IN: 8909 Purdue Road Suite 501 Indianapolis, IN 46268
Irving, TX : 2201 W. Royal Lane Suite 125 Irving, TX 75063
Memphis, TN : 8125 Sedgwick Way, Memphis TN 38125
Southfield, MI : 300 Galleria Officentre Southfield MI 48034
Orlando, FL : 12650 Ingenuity Dr Orlando FL 32826
Eden Prairie, MN : 11000 Prairie Lakes Drive Eden Prairie, MN 55344
Entry-level, Care Team Representative
Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?
A stable and consistent work environment in an office and/or virtual setting
A training program to learn how to help employees and customers from some of the world's most reputable brands.
An assigned mentor and manager who will guide you on your career journey.
Career development and promotional growth opportunities through increasing responsibilities
A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
See what a day in the life of a Care Team Representative is like: SED23026 - Mariah_01-09-24 (vidyard.com) (https://share.vidyard.com/watch/h1fLK1Cn1wdDjUxsnnUBjw?) & https://share.vidyard.com/watch/VCLjdFEUwPccjWaBtjLmwX
Learn more about our Care Team: Care Team (ceros.com) (https://view.ceros.com/sedgwick/care-team/p/1)
PRIMARY PURPOSE OF THE ROLE:
To provide excellent service displaying empathy to callers regarding claims for multiple lines of business, including but not limited to, expediting the claims process, and providing detailed claim notes on all calls, resolving issues with one call/one person response, and directing calls to appropriate escalation path as needed.
ARE YOU AN IDEAL CANDIDATE?
We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.
ESSENTIAL RESPONSIBLITIES MAY INCLUDE
Provide excellent customer service to external customers and internal support to an assigned team.
Act as a liaison between customers and team members; direct calls to appropriate escalation path as needed.
Provide detailed notes on phone calls, and track and code documentation according to standard processes.
Educate and inform customers about processes, timelines and status of inquiries via multiple communication channels.
Resolve issues with one call/ one-person responses.
Investigate customer feedback.
Track trends
Assist with developing corrective/preventative actions.
Perform administrative tasks.
QUALIFICATIONS
Education & Licensing: High school diploma or GED required.
Skills: Strong oral and written communication, computer literate - including Microsoft Office, organizational skills required
PC literate, including Microsoft Office products, Windows environment.
Must meet minimum typing requirements.
Experience: Clerical or customer service experience or equivalent combination of education and experience preferred
TAKING CARE OF YOU
Entry-level colleagues are offered a world class training program with a comprehensive curriculum.
An assigned mentor and manager that will support and guide you on your career journey.
Career development and promotional growth opportunities
A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more.
APPLICATION PROCESS
You will complete a recorded video interview as part of our application process. Upon completion of the video interview and application submittal, you will receive an email confirmation that your application was successfully completed. If you do not receive an email notification, please log back into your candidate account and submit your application. Our team will give careful consideration while reviewing your application and information you provided against the position's criteria. If there is mutual interest, we will contact you directly.
Work environment requirements for entry-level opportunities include -
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking.
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
#entrylevel
#contractcenterrep
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)
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
Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:
Eden Prairie, MN : 11000 Prairie Lakes Drive Eden Prairie, MN 55344
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.
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)
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 Team Lead | New England Jurisdictions | Open to Remote
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 (66,275 - 94,785). 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)
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
Care Team Representative
Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:
Dubuque, IA : 4141 Westmark Drive, Dubuque, IA 52002
Cedar Rapids, IA : 333 1st Street SE Ste. 200 Cedar Rapids IA 52401
Coralville, IA: 3273 Ridgeway Drive Coralville IA 52241
Dublin, OH : 5500 Glendon Court Dublin OH 43016
New Albany, OH : 7795 Walton Parkway New Albany, OH 43054
Indianapolis, IN: 8909 Purdue Road Suite 501 Indianapolis, IN 46268
Irving, TX : 2201 W. Royal Lane Suite 125 Irving, TX 75063
Memphis, TN : 8125 Sedgwick Way, Memphis TN 38125
Southfield, MI : 300 Galleria Officentre Southfield MI 48034
Orlando, FL : 12650 Ingenuity Dr Orlando FL 32826
Eden Prairie, MN : 11000 Prairie Lakes Drive Eden Prairie, MN 55344
Entry-level, Care Team Representative
Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?
A stable and consistent work environment in an office and/or virtual setting
A training program to learn how to help employees and customers from some of the world's most reputable brands.
An assigned mentor and manager who will guide you on your career journey.
Career development and promotional growth opportunities through increasing responsibilities
A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
See what a day in the life of a Care Team Representative is like: SED23026 - Mariah_01-09-24 (vidyard.com) (https://share.vidyard.com/watch/h1fLK1Cn1wdDjUxsnnUBjw?) & https://share.vidyard.com/watch/VCLjdFEUwPccjWaBtjLmwX
Learn more about our Care Team: Care Team (ceros.com) (https://view.ceros.com/sedgwick/care-team/p/1)
PRIMARY PURPOSE OF THE ROLE:
To provide excellent service displaying empathy to callers regarding claims for multiple lines of business, including but not limited to, expediting the claims process, and providing detailed claim notes on all calls, resolving issues with one call/one person response, and directing calls to appropriate escalation path as needed.
ARE YOU AN IDEAL CANDIDATE?
We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.
ESSENTIAL RESPONSIBLITIES MAY INCLUDE
Provide excellent customer service to external customers and internal support to an assigned team.
Act as a liaison between customers and team members; direct calls to appropriate escalation path as needed.
Provide detailed notes on phone calls, and track and code documentation according to standard processes.
Educate and inform customers about processes, timelines and status of inquiries via multiple communication channels.
Resolve issues with one call/ one-person responses.
Investigate customer feedback.
Track trends
Assist with developing corrective/preventative actions.
Perform administrative tasks.
QUALIFICATIONS
Education & Licensing: High school diploma or GED required.
Skills: Strong oral and written communication, computer literate - including Microsoft Office, organizational skills required
PC literate, including Microsoft Office products, Windows environment.
Must meet minimum typing requirements.
Experience: Clerical or customer service experience or equivalent combination of education and experience preferred
TAKING CARE OF YOU
Entry-level colleagues are offered a world class training program with a comprehensive curriculum.
An assigned mentor and manager that will support and guide you on your career journey.
Career development and promotional growth opportunities
A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more.
APPLICATION PROCESS
You will complete a recorded video interview as part of our application process. Upon completion of the video interview and application submittal, you will receive an email confirmation that your application was successfully completed. If you do not receive an email notification, please log back into your candidate account and submit your application. Our team will give careful consideration while reviewing your application and information you provided against the position's criteria. If there is mutual interest, we will contact you directly.
Work environment requirements for entry-level opportunities include -
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking.
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
#entrylevel
#contractcenterrep
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)
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
Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:
Eden Prairie, MN : 11000 Prairie Lakes Drive Eden Prairie, MN 55344
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.
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)
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
Care Team Representative
Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:
Dubuque, IA : 4141 Westmark Drive, Dubuque, IA 52002
Cedar Rapids, IA : 333 1st Street SE Ste. 200 Cedar Rapids IA 52401
Coralville, IA: 3273 Ridgeway Drive Coralville IA 52241
Dublin, OH : 5500 Glendon Court Dublin OH 43016
New Albany, OH : 7795 Walton Parkway New Albany, OH 43054
Indianapolis, IN: 8909 Purdue Road Suite 501 Indianapolis, IN 46268
Irving, TX : 2201 W. Royal Lane Suite 125 Irving, TX 75063
Memphis, TN : 8125 Sedgwick Way, Memphis TN 38125
Southfield, MI : 300 Galleria Officentre Southfield MI 48034
Orlando, FL : 12650 Ingenuity Dr Orlando FL 32826
Eden Prairie, MN : 11000 Prairie Lakes Drive Eden Prairie, MN 55344
Entry-level, Care Team Representative
Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?
A stable and consistent work environment in an office and/or virtual setting
A training program to learn how to help employees and customers from some of the world's most reputable brands.
An assigned mentor and manager who will guide you on your career journey.
Career development and promotional growth opportunities through increasing responsibilities
A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
See what a day in the life of a Care Team Representative is like: SED23026 - Mariah_01-09-24 (vidyard.com) (https://share.vidyard.com/watch/h1fLK1Cn1wdDjUxsnnUBjw?) & https://share.vidyard.com/watch/VCLjdFEUwPccjWaBtjLmwX
Learn more about our Care Team: Care Team (ceros.com) (https://view.ceros.com/sedgwick/care-team/p/1)
PRIMARY PURPOSE OF THE ROLE:
To provide excellent service displaying empathy to callers regarding claims for multiple lines of business, including but not limited to, expediting the claims process, and providing detailed claim notes on all calls, resolving issues with one call/one person response, and directing calls to appropriate escalation path as needed.
ARE YOU AN IDEAL CANDIDATE?
We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.
ESSENTIAL RESPONSIBLITIES MAY INCLUDE
Provide excellent customer service to external customers and internal support to an assigned team.
Act as a liaison between customers and team members; direct calls to appropriate escalation path as needed.
Provide detailed notes on phone calls, and track and code documentation according to standard processes.
Educate and inform customers about processes, timelines and status of inquiries via multiple communication channels.
Resolve issues with one call/ one-person responses.
Investigate customer feedback.
Track trends
Assist with developing corrective/preventative actions.
Perform administrative tasks.
QUALIFICATIONS
Education & Licensing: High school diploma or GED required.
Skills: Strong oral and written communication, computer literate - including Microsoft Office, organizational skills required
PC literate, including Microsoft Office products, Windows environment.
Must meet minimum typing requirements.
Experience: Clerical or customer service experience or equivalent combination of education and experience preferred
TAKING CARE OF YOU
Entry-level colleagues are offered a world class training program with a comprehensive curriculum.
An assigned mentor and manager that will support and guide you on your career journey.
Career development and promotional growth opportunities
A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more.
APPLICATION PROCESS
You will complete a recorded video interview as part of our application process. Upon completion of the video interview and application submittal, you will receive an email confirmation that your application was successfully completed. If you do not receive an email notification, please log back into your candidate account and submit your application. Our team will give careful consideration while reviewing your application and information you provided against the position's criteria. If there is mutual interest, we will contact you directly.
Work environment requirements for entry-level opportunities include -
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking.
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
#entrylevel
#contractcenterrep
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)
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 Examiner - Workers Compensation (Hybrid- Philadephia, PA)
PRIMARY PURPOSE : To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Analyzes and processes complex or technically difficult workers' compensation 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.
Negotiates settlement of claims within designated authority.
Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
Prepares necessary state fillings within statutory limits.
Manages the litigation process; ensures timely and cost effective claims resolution.
Coordinates vendor referrals for additional investigation and/or litigation management.
Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
Communicates claim activity and processing with the claimant and 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.
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. Professional certification as applicable to line of business preferred.
Experience
Five (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.
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
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.
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)
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 Examiner - Workers Compensation (Hybrid in any CA Office)
PRIMARY PURPOSE : To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Analyzes and processes complex or technically difficult workers' compensation 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.
Negotiates settlement of claims within designated authority.
Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
Prepares necessary state fillings within statutory limits.
Manages the litigation process; ensures timely and cost effective claims resolution.
Coordinates vendor referrals for additional investigation and/or litigation management.
Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
Communicates claim activity and processing with the claimant and 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.
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. Professional certification as applicable to line of business preferred.
Experience
Five (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.
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
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.
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 $85K-90K . 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)
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
Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:
Eden Prairie, MN : 11000 Prairie Lakes Drive Eden Prairie, MN 55344
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.
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)
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
Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:
Eden Prairie, MN : 11000 Prairie Lakes Drive Eden Prairie, MN 55344
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.
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)
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
Claim Associate - Workers Compensation
Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:
Southfield, MI : 300 Galleria Officentre Southfield MI 48034
PRIMARY PURPOSE : To analyze reported lower-level workers compensation claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Adjusts medical-only claims and minor lost-time workers compensation claims under close supervision.
Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.
Processes workers compensation claims determining compensability and benefits due; monitors reserve accuracy, and files necessary documentation with state agency.
Communicates claim action/processing with claimant, client and appropriate medical contact.
Ensures claim files are properly documented and claims coding is correct.
May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.
Maintains professional client relationships.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
QUALIFICATION
Education & Licensing
High school diploma or GED required. Licenses as required.
Experience
One (1) year of general office experience or equivalent combination of education and experience required. Claims industry experience preferred.
Skills & Knowledge
Excellent oral and written communication 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)
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 : To process claims and determine benefits due pursuant to a disability plan; to make timely payments and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets; and to ensure the ongoing processing of claims.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Makes claim determinations to approve non-complex disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
Determines benefits due, makes timely claims payments 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 either by phone, written correspondence and/or claims system.
Refers cases as appropriate to team lead; maintains professional client relationships.
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. College preferred.
Experience
Two (2) years of related experience or equivalent combination of education and experience required to include one (1) year general office or customer service experience. One (1) year of benefits or claims management experience preferred.
Skills & Knowledge
Excellent oral and written communication
PC literate, including Microsoft Office products
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 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)
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 Rancho Cordova, CA)
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
. Flexible work schedule
. Referral incentive program
. Opportunity to work in an agile environment. 3 days in-office
. Career development and promotional growth opportunities
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.
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 $100K -105K . 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)
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
Liability Claims Examiner | Hybrid Schedule | Litigation, Property Damage & Bodily Injury Experience
Hybrid or Remote - depending on location
Litigation, Property Damage & Bodily Injury Experience
Will have to obtain NY & HI licensing (Sedgwick will cover cost*)
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 examiner 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? To analyze Liability 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.
PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
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: 5 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.
TAKING CARE OF YOU
Flexible work schedule.
Referral incentive program.
Opportunity to work in an agile environment. [IF APPLICABLE]
Career development and promotional growth opportunities.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
Work environment requirements for entry-level opportunities include -
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
#claims
#claimsexaminer
#hybrid
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)
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
Liability Claims Examiner | Hybrid Schedule
5 years of liability claims management experience required
At least 3 years of injury litigation experience in Auto, General Liability or Product Liability 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 examiner 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? To analyze Liability Claims Examiner 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.
PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
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: 5 years of claims management experience or equivalent combination of education and experience required.
At least 3 years of litigation 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.
TAKING CARE OF YOU
Flexible work schedule.
Referral incentive program.
Opportunity to work in an agile environment.
Career development and promotional growth opportunities.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
WORK ENVIRONMENT REQUIREMENTS
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
#claimsexaminer
#hybri
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)
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
Admin/Adjuster
PRIMARY PURPOSE : To handle losses and claims for property and casualty insurers.
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)
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
Call Center Admin - In-office Dallas, TX. - Seasonal
PRIMARY PURPOSE : To provide administrative support including phone calls, preparing correspondence and reports, filing and other general office support activities.
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.
.
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)
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
IT Support Specialist
PRIMARY PURPOSE : To serve as a system support quality assurance lead with the responsibility of providing leadership for overall support quality; to provide guidance and mentoring; to provide an escalation quality validation point; to identify, research and resolve complex technical problems; to create and manage escalation procedures and ensure service levels are maintained; to perform required documentation and monthly quality ticket review; and track and monitor issues ensuring resolution in a timely manner.
ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work, are customer-oriented and are naturally empathetic.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Provides leadership, direction, and support to a team of IT Support colleagues.
Ensures IT Support processes and procedures are adhered to and departmental objectives are met.
Acts as quality assurance by identifying, researching, resolving and responding to technical and non-technical issues or questions from internal and external customers.
Monitors workloads and status; supports colleagues by providing advice on handling complex issues.
Ensures company customer service standards are met.
Communicates high visibility issues to immediate supervisor.
Maintains good client relationships.
Serves as a final level of quality for issue escalation research.
Continues to identify areas of improvement (process or employee).
Identifies, researches, replicates issues, resolves and responds to issues or questions received from internal and external customers as needed.
Manages complex troubleshooting and software development issues as needed.
Maintains intimate knowledge of claim systems, adjuster job functions and company workflow and processes as needed to solve support related issues.
Escalates calls to the appropriate departments as needed.
Assists in the resolution of support issues to decrease downtime and to bring about high levels of satisfaction as needed.
Provides status and follow-up information to internal or external customers as needed.
QUALIFICATIONS
Six (6) years of Help Desk or technical support service experience or equivalent combination of education and experience required.
Education & Licensing
Bachelor's degree from an accredited college or university preferred.
Skills & Knowledge
Excellent customer service skills
Proven understanding and knowledge of Quality
Good knowledge of service center processes and procedures
PC literate, including Microsoft Office products
Leadership/management/motivational skills
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Excellent negotiation skills
Good judgment and discretion skills
Ability to manage multiple projects and set priorities
Ability to work in a team environment
Ability to meet or exceed Performance Competencies
Ability to complete required number of monthly quality monitors
TAKING CARE OF YOU
Entry-level colleagues are offered a world class training program with a comprehensive curriculum
An assigned mentor and manager that will support and guide you on your career journey
Career development and promotional growth opportunities
A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more
Work environment requirements for entry-level opportunities include -
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines
NEXT STEPS
If your application is selected to advance to the next round, you will receive an e-mail notification with instructions and a recruiter will be in touch.
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)
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 Examiner Workers Compensation (Hybrid Rancho Cordova, CA)
PRIMARY PURPOSE : To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Analyzes and processes complex or technically difficult workers' compensation 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.
Negotiates settlement of claims within designated authority.
Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
Prepares necessary state fillings within statutory limits.
Manages the litigation process; ensures timely and cost effective claims resolution.
Coordinates vendor referrals for additional investigation and/or litigation management.
Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
Communicates claim activity and processing with the claimant and 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.
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. Professional certification as applicable to line of business preferred.
Experience
Five (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.
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
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.
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 $85K-90K . 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)
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 Team Lead | New England Jurisdictions | Open to Remote
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 (66,275 - 94,785). 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)
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 Examiner - Workers Compensation
OR/WA claims experience; moreso WA experience
PRIMARY PURPOSE : To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Analyzes and processes complex or technically difficult workers' compensation 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.
Negotiates settlement of claims within designated authority.
Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
Prepares necessary state fillings within statutory limits.
Manages the litigation process; ensures timely and cost effective claims resolution.
Coordinates vendor referrals for additional investigation and/or litigation management.
Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
Communicates claim activity and processing with the claimant and 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.
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. Professional certification as applicable to line of business preferred.
Experience
Five (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.
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
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.
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)
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
Care Team Representative
Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:
Dubuque, IA : 4141 Westmark Drive, Dubuque, IA 52002
Cedar Rapids, IA : 333 1st Street SE Ste. 200 Cedar Rapids IA 52401
Coralville, IA: 3273 Ridgeway Drive Coralville IA 52241
Dublin, OH : 5500 Glendon Court Dublin OH 43016
New Albany, OH : 7795 Walton Parkway New Albany, OH 43054
Indianapolis, IN: 8909 Purdue Road Suite 501 Indianapolis, IN 46268
Irving, TX : 2201 W. Royal Lane Suite 125 Irving, TX 75063
Memphis, TN : 8125 Sedgwick Way, Memphis TN 38125
Southfield, MI : 300 Galleria Officentre Southfield MI 48034
Orlando, FL : 12650 Ingenuity Dr Orlando FL 32826
Eden Prairie, MN : 11000 Prairie Lakes Drive Eden Prairie, MN 55344
Entry-level, Care Team Representative
Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?
A stable and consistent work environment in an office and/or virtual setting
A training program to learn how to help employees and customers from some of the world's most reputable brands.
An assigned mentor and manager who will guide you on your career journey.
Career development and promotional growth opportunities through increasing responsibilities
A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
See what a day in the life of a Care Team Representative is like: SED23026 - Mariah_01-09-24 (vidyard.com) (https://share.vidyard.com/watch/h1fLK1Cn1wdDjUxsnnUBjw?) & https://share.vidyard.com/watch/VCLjdFEUwPccjWaBtjLmwX
Learn more about our Care Team: Care Team (ceros.com) (https://view.ceros.com/sedgwick/care-team/p/1)
PRIMARY PURPOSE OF THE ROLE:
To provide excellent service displaying empathy to callers regarding claims for multiple lines of business, including but not limited to, expediting the claims process, and providing detailed claim notes on all calls, resolving issues with one call/one person response, and directing calls to appropriate escalation path as needed.
ARE YOU AN IDEAL CANDIDATE?
We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.
ESSENTIAL RESPONSIBLITIES MAY INCLUDE
Provide excellent customer service to external customers and internal support to an assigned team.
Act as a liaison between customers and team members; direct calls to appropriate escalation path as needed.
Provide detailed notes on phone calls, and track and code documentation according to standard processes.
Educate and inform customers about processes, timelines and status of inquiries via multiple communication channels.
Resolve issues with one call/ one-person responses.
Investigate customer feedback.
Track trends
Assist with developing corrective/preventative actions.
Perform administrative tasks.
QUALIFICATIONS
Education & Licensing: High school diploma or GED required.
Skills: Strong oral and written communication, computer literate - including Microsoft Office, organizational skills required
PC literate, including Microsoft Office products, Windows environment.
Must meet minimum typing requirements.
Experience: Clerical or customer service experience or equivalent combination of education and experience preferred
TAKING CARE OF YOU
Entry-level colleagues are offered a world class training program with a comprehensive curriculum.
An assigned mentor and manager that will support and guide you on your career journey.
Career development and promotional growth opportunities
A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more.
APPLICATION PROCESS
You will complete a recorded video interview as part of our application process. Upon completion of the video interview and application submittal, you will receive an email confirmation that your application was successfully completed. If you do not receive an email notification, please log back into your candidate account and submit your application. Our team will give careful consideration while reviewing your application and information you provided against the position's criteria. If there is mutual interest, we will contact you directly.
Work environment requirements for entry-level opportunities include -
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking.
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
#entrylevel
#contractcenterrep
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)
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 Examiner - Workers Compensation (Hybrid in any CA Office)
PRIMARY PURPOSE : To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Analyzes and processes complex or technically difficult workers' compensation 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.
Negotiates settlement of claims within designated authority.
Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
Prepares necessary state fillings within statutory limits.
Manages the litigation process; ensures timely and cost effective claims resolution.
Coordinates vendor referrals for additional investigation and/or litigation management.
Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
Communicates claim activity and processing with the claimant and 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.
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. Professional certification as applicable to line of business preferred.
Experience
Five (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.
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
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.
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 $85K-90K . 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)
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
Crisis Care Triage Nurse
PRIMARY PURPOSE OF THE ROLE: Provide timely response to catastrophic referrals from clients; confirm the injured worker (IW) location, obtain the current medical status, communicate appropriate information to facilitate Field Case Manager (FCM) onsite hospital visits, and maintain communication with the appropriate contacts until the FCM arrives onsite.
This is a 32 hour per week position covering triage for the Crisis Care Department during business hours; 6am-9pm Central Time. In addition, one weekend, Saturday 6am-Monday 6am on call per month is mandatory. Occasional weekend, evening, overnight, and holiday on call coverage is required to meet department PTO needs. This person will work a 6.4 hour day Mon-Friday- flexible -between 1:00-9:00pm CST.
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 in 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
Applies all phases of the nursing process, i.e. assessment, planning, implementation and evaluation when triaging calls.
Identifies life-threatening emergencies and recommends appropriate interventions.
Adheres to quality assurance standards.
Serves as resource to triage team members.
EDUCATION AND LICENSING
Bachelor's degree in nursing (BSN) preferred. Active unrestricted RN compact licensure required along with two year (2) years of recent clinical practice experience. Should be proficient in multiple screens and multiple computer applications.
TAKING CARE OF YOU BY
Seeks innovative customer solutions .
Craves cutting edge opportunities.
Wants dynamic company culture.
Passion about creativity.
Seeks ongoing learning as a person and professional.
Thrives when solving challenging problems.
Wants achievements to be celebrated.
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 , a recruiter will be in touch.
#NURSE
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.
Always accepting applications.
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)
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
PPO Provider Contractor
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.
ADDITIONAL FUNCTIONS and RESPONSBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
QUALIFICATIONS
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 ( $46,000 - $65,000 ). 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)