Location: Telecommuter
Company: Sedgwick Claims Management Services
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 Work Most Loved Workplace Forbes Best-in-State Employer Workers Compensation Claims Examiner (Remote)Are you
looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands? Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights. Take advantage of a variety of professional development
opportunities that help you perform your best work and grow your career.
Enjoy flexibility and autonomy in your daily work, your location, and your career path. Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion. OFFICE LOCATIONS Remote 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. Experience handling claims for IL and TN preferred. 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 TAKING CARE OF YOU Flexible work schedule. Referral incentive program. Career development and promotional growth opportunities.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one. SALARY TRANSPARENCY - CO, NY, WA, CA 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 $80,000 - $90,000 annually. 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.
#claiminteractionaminer #claims Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles. Requisition #: R45327tcv57hlu2
the following position in our NYC office. RESPONSIBILITIES: Be part of a collaborative team. Work with a wide range of clients. Provide innovative solutions to drive operational excellence as a core attribute throughout CSS. Continually maintain and refresh staff development plans and talent maps ensuring regular reviews.
Build strong relationships with stakeholders in broking, broking support, and regional offices Participate in and/or lead the charge for new automation for our clients. Measure performance for clients using messaging and provide regular feedback to them and the CSS client teams on those accounts. Establish clear goals and targets for implementing inbound messaging with
clients. Lead regional team of technicians working to test and implement inbound messaging. QUALIFICATIONS: BA/BS degree in finance, economics, or other business-related areas.
At least 5+ years of applicable experience. Analytical skills and attention to detail, ability to multi-task, manage multiple priorities and work in a rapidly changing environment. Electronic messaging experience in Insurance or Reinsurance. Proficiency in Excel and Microsoft office. Previous experience managing or directing others work. Writing and communication skills. Consultative and sales skills a plus. 1. ) Please elaborate candidate's Electronic messaging experience in Insurance or Reinsurance 2. ) Please
provide the link to candidates Linked In profile: 3. ) What is the candidates work authorization status?
4. ) What is the candidates highest level of education? 5. ) Has the candidate applied or been interviewed for any role with this company in the past? If so, please provide details. 6. ) What is the candidates desired total compensation? (Please specify base salary mission/bonus expectation) 7. ) Where is the candidate located? If candidate is not near the job location, please explain relocation plan in detail (e. g. timeline, relocating with family, selling/buying property)
answering questions, and resolving issues that may arise. The Commercial Lines Account Manager will work closely with the sales team to understand client and prospect needs, submit coverage specifications, obtain quotes from potential carriers, and negotiate/secure the best carrier coverage.
The role offers a competitive salary, attractive benefits and a flexible hybrid work style of 3 days in the office and 2 days from home. Pay Range: $85,000 - $110,000 DOE Responsibilities: Manage accounts, including coordinating services, answering questions, and resolving problems Work closely with the sales team to understand client and prospect needs Submit coverage specifications and obtain
quotes from potential carriers for new and renewal business Maintain accounts/policies Research and resolve any coverage issues, audit issues, or billing discrepancies Support new and existing clients with any inquiries Negotiate and secure the best carrier coverage based on clients' needs Remarket accounts in construction, servicing restaurants and servicing them Requirements: At least 3 years of experience in Commercial Insurance Experience as a Commercial Lines Account Executive is preferred Must hold a Property/Casualty License Experience with construction, restaurants, habitational commercial real estate customer types Experience working with AMS360 is preferred Bachelor's degree
is preferred Benefits: BCBS Health Insurance - 60% coverage for employee Group life insurance 401k with 3% match Vacation/PTO/Sick - 2 weeks Paid holidays - 7 or 8 with 2 floating holidays Incentive program for commercial lines Holiday bonus If you're looking for a challenging but rewarding career, apply for this position today!
#INDOPS #LI-POST #LI-HYBRID
U. S. economy with our goal to reach Real Zero carbon emissions from our operations by 2045 while improving customer affordability and reliability. Are you interested in creating a cleaner environment for future generations? Join our world-class, innovative team today.
Position Specific Description The Senior Insurance Auditor will be based in our Juno Beach office and will report to the Chief Compliance Officer of Palms Insurance and will conduct financial, operational, and compliance audits and advisory projects across all areas of our business. This challenging position will provide consultative support to business partners to identify solutions to address audit findings, and opportunities
for control improvements with the objective of mitigating risk and improving financial and operational performance. Audit areas may include Accounting, IT, Finance, Operations, Claims, and TPA.
Responsibilities will also include advising management on creating/updating process narratives, and flowcharts, performing walkthroughs, control testing, updating deficiency reports, providing control updates to management periodically, documenting action plans, and assisting process owners on ways to improve their processes and working with external auditors as required. The role requires a strong insurance and financial mindset, ability to build good working relationships with process owners
and management, effective communication skills and ability to multi-task when required.
Bachelor's degree in Accounting (or similar major), experience with insurance audit processes, procedures and methodologies and insurance carrier or broker experience. In turn for your hard work and excellent audit performance, we provide competitive pay/benefits, work life balance and opportunities for advancement across the organization. Job Overview Employees in this position contribute to audit and controls consultation projects by identifying and documenting risk exposure, processes and controls related to insurance, providing controls recommendations and best practices, and also testing manual and systematic controls.
Employees document audit results in work papers and report audit results to Management. Job Duties & Responsibilities Establish an insurance audit framework/charter, including evaluating internal processes and controls, meeting audit objectives within a scheduled time frame Create audit guidelines, questionnaires, and report templates to be utilized in all audits to maintain consistency Conduct or oversee Finance, Claims, Compliance, Operations, IT/Data Security & Retention, OFAC compliance Recommends process improvements Communicates verbally and in writing, with coworkers, Management, and customers Recommend process improvements Assist in the presentation of verbal and written audit reports to Management Partner with Next Era Internal Audit team.
Performs other job-related duties as assigned Job Overview This job Identifies, evaluates, and improves the effectiveness of company governance, risk management, and financial reporting controls and operational efficiencies. Job Duties & Responsibilities Oversees and directs a team of internal auditors responsible for multiple audits, SOX control testing and related reporting Meets and consults with business unit management on audit related matters Advises and provides insight to Executive Management on related audit findings Presents Audit Committee with an independent appraisal of the adequacy and effectiveness of the company's system of internal controls Performs other job-related duties as assigned Required Qualifications High School Grad / GEDBachelor's or Equivalent ExperienceExperience:10+ yearsSupervisor/Management Experience:5+ years Preferred Qualifications Certified Public Accountant (CPA)Master's Degree Employee Group: Exempt Employee Type: Full Time Job Category: Audit Organization: Palms Management Services, LLC Relocation Provided: Yes, if applicable Next Era Energy is an Equal Opportunity Employer.
Qualified applicants are considered for employment without regard to race, color, age, national origin, religion, marital status, interaction, interactionual orientation, gender identity, gender expression, genetics, disability, protected veteran status or any other basis prohibited by law. We are committed to a diverse and inclusive workplace. Next Era Energy and provides reasonable accommodation in its application and selection process for qualified individuals, including accommodations related to compliance with conditional job offer requirements, consistent with federal, state, and local laws.
Supporting medical or religious documentation will be required where applicable and permitted by applicable law. To request a reasonable accommodation, please send an e-mail to , providing your name, telephone number and the best time for us to reach you. Alternatively, you may call -xyz X. Please do not use this line to inquire about your application status. Next Era Energy will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.
However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information.
Next Era Energy does not accept any unsolicited resumes or referrals from any third-party recruiting firms or agencies. Please see our for more information. #LI-FB1 PDN-99de5da5-edc-0c3edf69d9f3
Mail/Calendar Soft Skill requirements (team fit/personality requirements) Exceptional Organizational Skills Able to Multi-task Strong Communication Skills Able to build and maintain strong working relationships1.
) Has the candidate applied or been interviewed for any role with this company in the past?
If so, please provide details. 2. ) Where is the candidate located? If candidate is not near the job location, please explain relocation plan in detail (e. g. timeline, relocating with family, selling/buying property) 3. ) What is the candidates desired total compensation? (Please specify base salary mission/bonus expectation) 4. ) Please provide the link to candidates Linked In
profile: 5. ) What is the candidates highest level of education? 6. ) What is the candidates work authorization status? 7. ) Is the candidate open and willing to travel upto 50% of time?
8. ) Please elaborate on the candidate's CAPPS programming knowledge and experience. Skills Intermediate Microsoft office skills Excel - Pivot Tables; Formulas Power Point - Able to edit or create Power Point Outlook Mail/Calendar Soft Skill requirements (team fit/personality requirements) Exceptional Organizational Skills Able to Multi-task Strong Communication Skills Able to build and maintain strong working relationships.
the following position in our NYC office. RESPONSIBILITIES: Be part of a collaborative team. Work with a wide range of clients. Provide innovative solutions to drive operational excellence as a core attribute throughout CSS. Continually maintain and refresh staff development plans and talent maps ensuring regular reviews.
Build strong relationships with stakeholders in broking, broking support, and regional offices Participate in and/or lead the charge for new automation for our clients. Measure performance for clients using messaging and provide regular feedback to them and the CSS client teams on those accounts. Establish clear goals and targets for implementing inbound messaging with
clients. Lead regional team of technicians working to test and implement inbound messaging. QUALIFICATIONS: BA/BS degree in finance, economics, or other business-related areas.
At least 5+ years of applicable experience. Analytical skills and attention to detail, ability to multi-task, manage multiple priorities and work in a rapidly changing environment. Electronic messaging experience in Insurance or Reinsurance. Proficiency in Excel and Microsoft office. Previous experience managing or directing others work. Writing and communication skills. Consultative and sales skills a plus. 1. ) Please elaborate candidate's Electronic messaging experience in Insurance or Reinsurance 2. ) Please
provide the link to candidates Linked In profile: 3. ) What is the candidates work authorization status?
4. ) What is the candidates highest level of education? 5. ) Has the candidate applied or been interviewed for any role with this company in the past? If so, please provide details. 6. ) What is the candidates desired total compensation? (Please specify base salary mission/bonus expectation) 7. ) Where is the candidate located? If candidate is not near the job location, please explain relocation plan in detail (e. g. timeline, relocating with family, selling/buying property)
answering questions, and resolving issues that may arise. The Commercial Lines Account Manager will work closely with the sales team to understand client and prospect needs, submit coverage specifications, obtain quotes from potential carriers, and negotiate/secure the best carrier coverage.
The role offers a competitive salary, attractive benefits and a flexible hybrid work style of 3 days in the office and 2 days from home. Pay Range: $85,000 - $110,000 DOE Responsibilities: Manage accounts, including coordinating services, answering questions, and resolving problems Work closely with the sales team to understand client and prospect needs Submit coverage specifications and obtain
quotes from potential carriers for new and renewal business Maintain accounts/policies Research and resolve any coverage issues, audit issues, or billing discrepancies Support new and existing clients with any inquiries Negotiate and secure the best carrier coverage based on clients' needs Remarket accounts in construction, servicing restaurants and servicing them Requirements: At least 3 years of experience in Commercial Insurance Experience as a Commercial Lines Account Executive is preferred Must hold a Property/Casualty License Experience with construction, restaurants, habitational commercial real estate customer types Experience working with AMS360 is preferred Bachelor's degree
is preferred Benefits: BCBS Health Insurance - 60% coverage for employee Group life insurance 401k with 3% match Vacation/PTO/Sick - 2 weeks Paid holidays - 7 or 8 with 2 floating holidays Incentive program for commercial lines Holiday bonus If you're looking for a challenging but rewarding career, apply for this position today!
#INDOPS #LI-POST #LI-HYBRID
U. S. economy with our goal to reach Real Zero carbon emissions from our operations by 2045 while improving customer affordability and reliability. Are you interested in creating a cleaner environment for future generations? Join our world-class, innovative team today.
Position Specific Description The Senior Insurance Auditor will be based in our Juno Beach office and will report to the Chief Compliance Officer of Palms Insurance and will conduct financial, operational, and compliance audits and advisory projects across all areas of our business. This challenging position will provide consultative support to business partners to identify solutions to address audit findings, and opportunities
for control improvements with the objective of mitigating risk and improving financial and operational performance. Audit areas may include Accounting, IT, Finance, Operations, Claims, and TPA.
Responsibilities will also include advising management on creating/updating process narratives, and flowcharts, performing walkthroughs, control testing, updating deficiency reports, providing control updates to management periodically, documenting action plans, and assisting process owners on ways to improve their processes and working with external auditors as required. The role requires a strong insurance and financial mindset, ability to build good working relationships with process owners
and management, effective communication skills and ability to multi-task when required.
Bachelor's degree in Accounting (or similar major), experience with insurance audit processes, procedures and methodologies and insurance carrier or broker experience. In turn for your hard work and excellent audit performance, we provide competitive pay/benefits, work life balance and opportunities for advancement across the organization. Job Overview Employees in this position contribute to audit and controls consultation projects by identifying and documenting risk exposure, processes and controls related to insurance, providing controls recommendations and best practices, and also testing manual and systematic controls.
Employees document audit results in work papers and report audit results to Management. Job Duties & Responsibilities Establish an insurance audit framework/charter, including evaluating internal processes and controls, meeting audit objectives within a scheduled time frame Create audit guidelines, questionnaires, and report templates to be utilized in all audits to maintain consistency Conduct or oversee Finance, Claims, Compliance, Operations, IT/Data Security & Retention, OFAC compliance Recommends process improvements Communicates verbally and in writing, with coworkers, Management, and customers Recommend process improvements Assist in the presentation of verbal and written audit reports to Management Partner with Next Era Internal Audit team.
Performs other job-related duties as assigned Job Overview This job Identifies, evaluates, and improves the effectiveness of company governance, risk management, and financial reporting controls and operational efficiencies. Job Duties & Responsibilities Oversees and directs a team of internal auditors responsible for multiple audits, SOX control testing and related reporting Meets and consults with business unit management on audit related matters Advises and provides insight to Executive Management on related audit findings Presents Audit Committee with an independent appraisal of the adequacy and effectiveness of the company's system of internal controls Performs other job-related duties as assigned Required Qualifications High School Grad / GEDBachelor's or Equivalent ExperienceExperience:10+ yearsSupervisor/Management Experience:5+ years Preferred Qualifications Certified Public Accountant (CPA)Master's Degree Employee Group: Exempt Employee Type: Full Time Job Category: Audit Organization: Palms Management Services, LLC Relocation Provided: Yes, if applicable Next Era Energy is an Equal Opportunity Employer.
Qualified applicants are considered for employment without regard to race, color, age, national origin, religion, marital status, interaction, interactionual orientation, gender identity, gender expression, genetics, disability, protected veteran status or any other basis prohibited by law. We are committed to a diverse and inclusive workplace. Next Era Energy and provides reasonable accommodation in its application and selection process for qualified individuals, including accommodations related to compliance with conditional job offer requirements, consistent with federal, state, and local laws.
Supporting medical or religious documentation will be required where applicable and permitted by applicable law. To request a reasonable accommodation, please send an e-mail to , providing your name, telephone number and the best time for us to reach you. Alternatively, you may call -xyz X. Please do not use this line to inquire about your application status. Next Era Energy will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.
However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information.
Next Era Energy does not accept any unsolicited resumes or referrals from any third-party recruiting firms or agencies. Please see our for more information. #LI-FB1 PDN-99de5da5-edc-0c3edf69d9f3
Mail/Calendar Soft Skill requirements (team fit/personality requirements) Exceptional Organizational Skills Able to Multi-task Strong Communication Skills Able to build and maintain strong working relationships1.
) Has the candidate applied or been interviewed for any role with this company in the past?
If so, please provide details. 2. ) Where is the candidate located? If candidate is not near the job location, please explain relocation plan in detail (e. g. timeline, relocating with family, selling/buying property) 3. ) What is the candidates desired total compensation? (Please specify base salary mission/bonus expectation) 4. ) Please provide the link to candidates Linked In
profile: 5. ) What is the candidates highest level of education? 6. ) What is the candidates work authorization status? 7. ) Is the candidate open and willing to travel upto 50% of time?
8. ) Please elaborate on the candidate's CAPPS programming knowledge and experience. Skills Intermediate Microsoft office skills Excel - Pivot Tables; Formulas Power Point - Able to edit or create Power Point Outlook Mail/Calendar Soft Skill requirements (team fit/personality requirements) Exceptional Organizational Skills Able to Multi-task Strong Communication Skills Able to build and maintain strong working relationships.
individuals who value opportunity, mentoring and a chance to stand out. We are looking to add Personal Lines Account Managers to our team! In this role, you will engage and service new and existing clients with our industry-leading client relationships management process.
The successful candidate will possess: 220 or 440 license Problem solving aptitude An interest in continuous learning Passion for client engagement Ability to analyze market trends and apply to the client relationship 3+ years previous inside PL account management experience Excellent verbal and written communication skills College degree preferred Proficiency in Microsoft Suite Knowledge of AMS360 a plus Bilingual English/Spanish
a plus As a Personal Lines Account Manager at SBIR, you will be joining a team who thrive on constant learning and enjoy the freedom to exercise personal initiative, while working collaboratively, when desired.
We provide the tools and knowledge necessary to deliver high quality solutions and positive results for clients. Your role on the team will include overseeing new and renewal business, managing the marketing and binding process, fielding coverage questions, responding to claims concerns, and identifying coverage opportunities. If you are looking for a company that provides you with a chance to stand out, stand up and grow, while working and playing hard, wed love to hear from you
-- Setnor Byer Insurance & Risk. What we offer Competitive compensation with bonus potential Generous medical, dental and vision package 401K with a rich company match Life Insurance Short-term disability Rich paid time-off Paid holidays Flex start times Continuing education assistance Catered Lunches Monthly Massages Charitable matching Pet adoption reimbursement On-site gym Plus extra surprise rewards
