Jobs at Sedgwick

Processes auto and general liability property damage claims by analyzing coverage, liability, estimates, payments, documentation, subrogation, salvage, and claim resolution. Communicates with insureds, clients, agents, and brokers while meeting regulatory deadlines, maintaining claim files, supporting quality programs, and delivering professional service. State adjusting licenses may be required.

Analyze FMLA and paid leave claims, establish and track documentation, determine eligibility and benefit payments, calculate adjustments, make timely case decisions, and communicate outcomes with claimants and clients while maintaining service standards and compliance with policies and regulations.

Owns AI product backlog refinement, prioritization, requirements, user stories, acceptance criteria, stakeholder communication, and user acceptance testing. Partners with product managers, data scientists, ML engineers, and MLOps teams to translate AI capabilities into deliverable features. Monitors deployed AI functionality for performance, drift, and user feedback while tracking delivery risks, dependencies, metrics, and outcomes.

Manages claims quality and performance programs across workers’ compensation, general liability, auto, and property damage operations. Conducts audits, presents findings, coordinates quality initiatives, oversees colleague training and coaching, provides performance measurements, and supports operational improvement. Maintains claims and jurisdictional expertise while supervising staff, developing performance plans, and participating in national performance reviews. Travel is required as needed.

Analyze and adjudicate lost-time workers’ compensation claims in the NY jurisdiction. Investigate claims, gather information, determine exposure and benefits, develop action plans, negotiate settlements within authority, communicate with claimants and clients, and report claims to excess carriers. The role requires timely resolution, sound judgment, strong analysis, and compliance with service expectations and client requirements.

Handles property damage litigation caseloads, maintains case management records and diary dates, conducts preliminary investigations, gathers evidence and witness statements, obtains relevant documentation, and ensures protocol compliance. The role also involves developing digital case-management procedures, meeting time-recording and billing targets, and supporting insurer and corporate clients. Training and opportunities for a training contract or funded CILEX qualification are available.

Analyze and adjudicate general liability, auto liability, and premises claims. Investigate exposures, gather information, develop action plans, negotiate settlements within authority, communicate with claimants and clients, and report claims to excess carriers. The role requires multi-jurisdiction knowledge, claims management expertise, sound judgment, and applicable licensing.

Handles complex litigation and high-severity claims involving serious injuries, coverage disputes, legal inquiries, settlements, subrogation, and defense strategy. Coordinates with clients, counsel, investigators, and other stakeholders; manages liability reserves and expenses; participates in mediations, trials, arbitrations, and hearings; and develops strategies for timely, satisfactory case resolution.

Build and maintain production-grade data pipelines connecting legacy systems with Snowflake, AWS, and Azure platforms. Develop feature stores, optimized datasets, and vectorization pipelines supporting machine learning and generative AI. Orchestrate cross-cloud workflows, implement data quality and observability controls, optimize Snowflake performance and costs, and resolve enterprise connectivity and security challenges. Partner with MLOps, Data Science, IT, and security teams to deliver scalable data solutions.

Supervise multiple liability claims teams, providing technical and jurisdictional guidance on claim adjudication, quality reviews, appeals, reserves, litigation, and client relationships. Monitor workloads, reports, compliance, documentation, and high-exposure claims while identifying process improvements. Lead hiring, training, performance management, licensing compliance, and colleague development for claims examiners and technical staff.

Leads account management strategies for complex insurance clients, focusing on retention, satisfaction, renewals, revenue growth, and service improvements. Provides stewardship reporting, resolves major service issues, coordinates invoicing and audits, identifies cross-selling opportunities, and negotiates service plan changes. Partners with internal operations, technology, and business development teams to improve client outcomes. Supervises Client Services staff supporting large, multi-office programs.

Coordinate absence and disability programs for assigned clients, serve as liaison between client HR and internal teams, resolve escalated issues, maintain records, prepare and analyze program reports, monitor satisfaction, assist in training and benefits fairs, ensure compliance with legal requirements, and support continuous process improvement.

Lead regional claims operations, ensuring compliance, quality service delivery, staffing, training, budget and P&L management for multiple offices. Oversee performance, implement policies, support sales coordination, and develop staff including succession planning for 100-299 colleagues.

Manages full-cycle recruiting for assigned roles using AI-enabled tools, sourcing strategies, talent pipelines, structured selection practices, and recruiting analytics. Partners with hiring managers, validates AI-generated recommendations, coordinates candidate communications and offers, maintains accurate recruiting records, and ensures compliance with employment laws, privacy requirements, responsible AI principles, bias mitigation, and audit standards.

Owns end-to-end development and production operation of Generative AI agents, workflows, and full-stack applications. Builds with Python and React, deploys on AWS using Terraform and GitHub Actions, and implements evaluation, observability, security, and human-in-the-loop controls. Integrates enterprise systems, mentors junior engineers, partners with business and vendor teams, and leads troubleshooting and architectural improvements in regulated operational environments.

Analyzes and adjudicates lower-level workers compensation claims, determines compensability and benefits, maintains accurate reserves and documentation, processes routine payments and prescriptions, communicates with claimants and medical contacts, and supports senior claims representatives. The role also ensures coding accuracy, compliance with state filing requirements, professional client relationships, and adherence to organizational quality standards.

Leads enterprise AI architecture strategy, governance, and platform direction across Generative AI, Agentic AI, RAG, and LLM systems. Defines architecture roadmaps, standards, reusable patterns, integration frameworks, data foundations, and responsible AI controls across AWS and Azure. Oversees AI portfolio investments, value realization, production operations, vendor strategy, and executive stakeholder alignment while developing enterprise AI architecture talent.

Owns end-to-end technical outcomes for a value-stream pod, from shaping business problems through production operation. Designs and builds production Generative AI agents, workflows, and applications using Python, React, AWS, Terraform, and GitHub Actions. Establishes engineering, evaluation, observability, provenance, and human-review standards; guides architecture and vendor collaboration; prevents duplicate capabilities; troubleshoots business-critical AI services; and mentors engineers. Regular travel is required for on-site collaboration with claims, managed care, operations, and vendors.

Conduct desktop investigations into suspected fraud across commercial insurance claims, including property, theft, fire, liability, and business interruption. Manage caseloads, interpret policy coverage, analyze financial and documentary evidence, interview stakeholders, validate losses, negotiate settlements, and produce evidence-based reports. Ensure compliance with FCA principles, GDPR, internal governance, and service-level expectations while supporting insurer decision-making.

Supports Operations Support Services leadership by reviewing scanned documents, processing electronic mail, correcting claim information, following indexing protocols, meeting service-level and production goals, preparing reports, answering process questions, and coaching associates. Requires strong communication, organization, analytical ability, Microsoft Office proficiency, and teamwork. The role requires a high school diploma or GED, two years of general office experience, and a credit security clearance through a background credit check.