Jobs at Sedgwick

Adjudicate lost-time workers' compensation claims for NJ jurisdictions: investigate, analyze exposure, negotiate settlements within authority, communicate with claimants, clients, and excess carriers, and process claims to timely resolution while following client and industry requirements.

Support and maintain claims management systems, manage user security access, process claim adjustments and requests, run reports, coordinate audits, provide telephone support, gather data for audits and projects, and collaborate with internal teams to meet operational and security policies.

Entry-level traineeship to become a workers' compensation claims adjuster. Includes a 4-week training program, onboarding with mentor support, and supervised handling of claims: investigating incidents, obtaining medical and employer information, determining coverage and benefits, documenting files, communicating with stakeholders, and maintaining compliance with jurisdictional requirements.

Investigates and pursues complex third-party subrogation recoveries across jurisdictions and lines of business. Reviews claims, gathers evidence, manages liens, negotiations, litigation, counsel, vendors, payments, documentation, coding, and recovery reporting. Provides guidance to stakeholders, maintains active claim diaries, applies cost-containment strategies, and ensures timely, compliant claim resolution within client authority and service expectations.

Review and adjudicate lower-level liability and physical damage claims, determine compensability and benefits due, document files, communicate with claimants/clients/medical contacts, process routine payments and maintain reserve accuracy under supervision.

Manage and adjudicate lower-level general liability and physical damage claims: determine compensability and benefits, monitor reserves, document files accurately, communicate with claimants/clients/medical contacts, process routine payments/prescriptions, and support complex claims and quality programs.

Designs, develops, and delivers training programs and new-colleague orientation; assesses development needs and performance; creates lesson plans and evaluations; coordinates technical systems training; monitors development plans and supports quality programs. May travel as required.

Manage multiple client service programs or a large national program, maintain client/broker/vendor relationships, oversee renewals, invoicing, audits, reporting, and contracts. Act as primary client contact, drive client satisfaction, identify cross-sell opportunities, supervise staff, and support quality programs. Travel as required.

Provides customer service and internal support for workers’ compensation claims under clinical case management supervision. Responsibilities include managing caseloads, collecting and documenting claim data, facilitating treatment services, verifying return-to-work status, communicating with claim parties, and maintaining accurate records in the claim management system. Requires adherence to workers’ compensation laws, company policies, and established workflows.

Own the vision, roadmap, and backlog for data products. Translate client needs into user stories and acceptance criteria, coordinate with data engineering and analytics, track KPIs, support delivery and release readiness, and drive product adoption.

Coordinates client absence programs, serving as a liaison among clients, employees, healthcare providers, and internal operations. Supports program evaluation, reporting, compliance, documentation, surveys, process improvement, client training, benefits fairs, and medical evaluation approvals. Maintains absence program records and procedures while applying relevant legal requirements and best practices. Requires strong communication, analytical, organizational, negotiation, and interpersonal skills, along with six years of absence management experience.

Provides administrative and office support by preparing correspondence and reports, maintaining records and files, processing invoices, managing supplies, recording meeting minutes, arranging travel, researching topics, and supporting telephone and quality program activities.

Conducts evidence-based utilization reviews for injured employees by assessing medical records, treatment needs, compliance, psychosocial factors, and appropriate levels of care. Collaborates with physicians, claims examiners, clients, vendors, and nursing staff to support quality, cost-effective outcomes. Maintains confidentiality and complies with ethical, legal, accreditation, and regulatory standards in a remote work environment.

Oversee technical and operational functions for assigned claims clients, ensuring compliance, quality service delivery, audit readiness, and adherence to claims policies and regulations. Develop business plans, manage client relationships, oversee staffing and training, and prepare budgets and profit-and-loss reports. Lead hiring, performance management, colleague development, and operational quality reviews while managing fewer than 25 colleagues.

Provide general administrative support: prepare correspondence and reports, file and maintain records, handle phones and invoices, record meeting minutes, make travel arrangements, maintain supplies, and perform other assigned office duties.

Analyzes and adjudicates lower-level liability and physical damage claims under supervision. Determines compensability and benefits, monitors reserves, processes documentation and payments, communicates with claimants, clients, and medical contacts, ensures accurate coding and claim files, maintains client relationships, and supports quality programs.

Leads a remote and hybrid 24/7 Incident Response Team delivering Home Emergency and FNOL insurance claims services. Oversees service delivery, KPIs, SLAs, quality, customer experience, workforce planning, complaints, surge response, compliance, and client relationships. Develops operational leaders through coaching and succession planning, uses management information to improve efficiency, supports change and system initiatives, and provides leadership during major incidents and high-demand periods.

Provide clerical support to claims staff: enter and update claims, process payments, handle mail/filing, prepare and send correspondence and reports, answer phones and set medical appointments, assist customers, produce computer reports, and support quality and other assigned projects.

Provide clerical support to claims staff: set up and enter new claims, input notes/diaries, process payments and mail, prepare/send correspondence and reports, answer calls, schedule appointments, and perform general office and administrative tasks.

Analyze leave requests and determine paid leave benefits based on client plans and federal/state regulations. Establish and track FMLA claims, calculate and process payments/adjustments, communicate decisions with claimants and clients, maintain documentation and client relationships, and meet service standards.