By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.
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Account ConsultantPRIMARY PURPOSE: To manage claim caseload of basic to highly complex claims within granted authority level including related financial implications, along with financial implications and to mentor Account Representatives and Account Specialists.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
- Utilizes special account instructions to obtain individual customer information and adhere to instructions; identifies, initiates, and coordinates various specialized services such as subrogation, fraud evaluation or case management review to resolve claims.
- Establishes and maintains effective relationship with internal and external customers and coworkers; communicates effectively and timely.
- Mentors/coaches account representatives and account specialists; facilitates round table discussions within the assigned team.
- Investigates, evaluates and resolves claims; identifies potential problems/trends in claim files and takes corrective action or makes corrective recommendations; interprets medical reports and state law or jurisdictional law in claim handling.
- Applies jurisdictional and medical knowledge to properly assess the indemnity, medical and expense exposure of assigned claims and appropriately interprets and applies insurance coverage.
- Reviews client files and collaborates with team to prepare information which includes thorough analysis of file strategies, claims status and emerging trends.
- Proactively manages litigation in conjunction with client requirements; works constructively with client and legal representatives to resolve claims.
- Ensures compliance and best possible outcomes by minimizing financial liability.
- Compiles requirements in order to prevent penalties and fines; utilizes instructions and tools provided to ensure that all state required documentation is issued accurately and in timely manner in accordance with specific jurisdictional timeframes and guidelines.
- Monitors reports as assigned and documents compliance with key jurisdictional requirements (i.e. EDI, timeliness of benefit payments, etc.); assists Team Lead in tracking completion of team’s tasks and projects; reviews SAS/SOX documents and submits in timely manner; and assists with takeover and reverse takeover projects ensuring that claim files are transferred and handled appropriately.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
- Performs other duties as assigned.
- Supports the organization's quality program(s).
QUALIFICATIONS
Education & Licensing
Bachelor's degree from an accredited college or university preferred. State adjuster licenses required.
Experience
Six (6) years of related experience and/or training or equivalent combination of education and experience required.
Skills & Knowledge
- Thorough legal and jurisdictional knowledge based on line of business
- Strong oral and written communication, including presentation skills
- PC literate, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skills
- Excellent interpersonal skills
- Strong customer service 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.Skills Required
- State adjuster licenses
- Six years related experience and/or training or equivalent combination of education and experience
- Thorough legal and jurisdictional knowledge based on line of business
- PC literate, including Microsoft Office products
- Strong oral and written communication, including presentation skills
- Analytical and interpretive skills
- Strong organizational skills
- Excellent interpersonal and strong customer service skills
- Ability to mentor/coach account representatives and account specialists
- Bachelor's degree from an accredited college or university
Sedgwick Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Sedgwick and has not been reviewed or approved by Sedgwick.
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Leave & Time Off Breadth — Leave is positioned as a standout part of the package, with generous PTO levels cited (including multi-week starting allotments and higher accrual with tenure). Time-off and flexibility are often framed as meaningful offsets when evaluating the overall rewards mix.
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Healthcare Strength — Healthcare coverage is described as broad, spanning medical, dental, vision, disability/life, and mental-health offerings, with additional wellness and telemedicine-style services. The health suite is frequently characterized as solid, even when not viewed as best-in-class by everyone.
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Retirement Support — Retirement benefits include a 401(k) with employer matching and are grouped with other financial supports like HSA/FSA options. The match is viewed as a helpful baseline benefit, though generally not positioned as unusually rich.
Sedgwick Insights
What We Do
From our modest beginnings as a regional claims administrator, Sedgwick has grown into a leading global provider of technology-enabled risk, benefits and integrated business solutions with 31,000+ colleagues, located across 80 countries. Through innovative product development, organic business development and strategic acquisitions, Sedgwick’s offerings continue to evolve beyond claims processing to meet the current and future needs of our clients. Our approach to delivering quality service in areas such as workers’ compensation, liability, property, disability and absence management goes far beyond just managing claims—we aim to simplify the process and reduce complexity, making it easy and effective for everyone involve.
Why Work With Us
We stay tuned into what our colleagues want and need and deliver a world-class colleague experience that demonstrates how much we value their unique contributions to our business. You’ll see and feel what it’s like to work for a company that’s committed to doing the right thing – for those we serve, for our planet and for each other.
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