Claims Adjusters, Examiners, and Investigators

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

**Position Summary**

+ Review provider and member claims to determine if they meet CCR review requirements.

+ Follow applicable workflows, templates, and legal and compliance requirements to provide a complete picture of what is requiring review to the CCR clinicians and medical directors.

+ Organizes and prioritizes work to help meet regulatory and CCR claim turn around times.

+ Determines coverage, verifies eligibility, benefits, identifies discrepancies, and applies all Medical Claim Management policies and procedures to assist in ensuring claims are handled per policy and legal requirements.

+ Works with all appropriate internal and external departments and personnel to accurately review specified claims and/or clarify any issues found in the course of the review.

+ Maintains and utilizes all resource materials and systems to effectively manage job responsibilities.

+ Adheres to company policies to protect member confidentiality.

**Required Qualifications**

+ 2+ years claim processing experience and demonstrated ability to handle multiple assignments competently, accurately and efficiently.

+ Customer service experience

+ Knowledge of Medical Terminology

**Preferred Qualifications**

+ Claims processing experience

+ System knowledge: MedCompass, CEC, Rumba, etc.

**Education**

+ High School Diploma or G.E.D.

**Anticipated Weekly Hours**

40

**Time Type**

Full time

**Pay Range**

The typical pay range for this role is:

$18.50 - $42.35

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

**Great benefits for great people**

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

+ **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .

+ **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

+ **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 07/21/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

**Position Summary**

-Responsible for initial review and triage of claims tasked for review. -Determines coverage, verifies eligibility, identifies and redirects misdirects -Responsible for prepping the authorization in the system and triage cases to medical staff for review. -Organized and prioritizes work to meet regulatory and claim turn-around times -Promotes communication, both internally and externally to enhance effectiveness of medical management services and health care team. -Performs non-medical research and support -Adheres to Compliance with PM Policies and Regulatory Standards. -Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements. -Protects the confidentiality of member information and adheres to company policies regarding confidentiality. -Assist in the research and resolution of claims payment issue

**Required Qualifications**

Effective communication, telephonic and organization skills. Familiarity with basic medical terminology and concepts used in care . -Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members. -Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word

**Preferred Qualifications**

-2-4 years experience as a medical assistant, office assistant or claim processor

-ATV, HRP, or MedCompass

**Education** High School Diploma or G.E.D

**Anticipated Weekly Hours**

40

**Time Type**

Full time

**Pay Range**

The typical pay range for this role is:

$18.50 - $38.82

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

**Great benefits for great people**

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

+ **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .

+ **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

+ **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 07/23/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Our Company:

Established in 2012, Seek Now captures robust property data to meet the needs of customers across the insurance and real estate industries. With more than 2 million property inspections completed to date while currently servicing 3,000 properties per day, Seek Now is the leading data capture and inspection services firm serving 240+ customers.

Our mission is to help our customers make faster decisions and improve economic outcomes, all while providing a stellar customer experience. We accomplish this through continuously reimagining how information is captured, transformed, and transmitted across all the industries we serve.

Our vision is to be the leading provider of on-demand, ground truth property data solutions. We do this while creating individual growth opportunities for our employees, expanding network of Seekers, and value add partners.

Summary:

Seek Now is searching for capable 1099 independent sub-contractors to provide accurate, impartial, and complete home and commercial property inspections.

Our 1099 Field Inspectors are the frontline experts who assist and collect data for our clients in the Property Insurance, Facility Management, and Real Estate sectors.

Essential Expectations:

+ Ability and willingness to access and inspect steep and/or high roofs

+ Lift, carry, and set up ladders and other equipment up to 100 pounds

+ Sketch and measure roof and/or room components

+ Scope the area of different sized and shaped roofs, rooms, and other inspection areas

+ Perform accurate, impartial, and complete inspections, which includes but is not limited to identification of age and condition

+ Travel to perform inspections in areas hit by weather catastrophes when needed, which includes assignments averaging two (2) to six (6) weeks at a time

+ Lodging is provided by Seek Now which can include having a fellow Seek Now Sub-Contractor as a roommate

+ Ability to take assignments on short notice and complete all aspects of job assignments as defined

+ Represent our Core Values: Self-Starter, Visionary & Strategic, Lead with Humility

+ Strong attention to detail, organization, and time management skills with a focus on professionalism and customer service

+ Document inspections using our proprietary software application on your smartphone device

+ Be comfortable covering a 100-mile radius around your home market

+ Flexible in job assignment scheduling

+ Ability to utilize other equipment as needed including 3D Cameras, Drones, Moisture meters

Preferred Qualifications:

+ Roofing sales or construction experience

+ Property Insurance experience

+ Haag Certification

+ Ability to use a 40'-foot ladder

Minimum Requirements:

+ A clean and reliable truck, van, or SUV that is capable of transporting a 32' ft ladder safely

+ An operational laptop and smartphone

+ Ability to travel, especially during catastrophic events such as hurricanes and tornadoes

+ Ability to earn HAAG Certification within 90 days

+ Ability to use a laptop and a smartphone, which includes navigating between applications, entering data, and using Microsoft Office products

+ Ability to submit complete, quality reports on time

+ 32-foot ladder

+ Professional appearance

+ Valid driver's license

+ State Issued Workers Compensation

+ Certificate of General Liability Insurance

+ LLC Articles or Certificate of Organization

+ 1099 independent contractor

+ Seek Now operates 7-days a week, providing you the opportunity to be flexible with your availability

+ Great earning potential – six figures

+ Paid weekly.

+ Team-first environment

+ State-of-the-art, technology-based tool for inspections

+ Strong support team for our 1099 independent contractor field inspectors

+ Hotel fees paid/reimbursed on CAT jobs

Other Requirements:

+ Professional appearance

+ Valid driver's license

+ State Issued Worker's Compensation

+ Certificate of General Liability Insurance

+ LLC Articles or Certificate of Organization

Position Type and Hours:

+ 1099 independent contractor

+ Seek Now operates 7-days a week, providing you the opportunity to be flexible with your availability

Benefits and Perks:

+ Great earning potential – six figures

+ Paid weekly

+ Team-first environment

+ State-of-the-art, technology-based tool for inspections

+ Strong support team for our 1099 independent contractor field inspectors

+ Hotel fees paid/reimbursed on CAT jobs

Disclaimer:

This description is not designed to cover or contain a comprehensive listing of activities, expectations, or functions that are required of the contractor.

Our Company:

Established in 2012, Seek Now captures robust property data to meet the needs of customers across the insurance and real estate industries. With more than 2 million property inspections completed to date while currently servicing 3,000 properties per day, Seek Now is the leading data capture and inspection services firm serving 240+ customers.

Our mission is to help our customers make faster decisions and improve economic outcomes, all while providing a stellar customer experience. We accomplish this through continuously reimagining how information is captured, transformed, and transmitted across all the industries we serve.

Our vision is to be the leading provider of on-demand, ground truth property data solutions. We do this while creating individual growth opportunities for our employees, expanding network of Seekers, and value add partners.

Summary:

Seek Now is searching for capable 1099 independent sub-contractors to provide accurate, impartial, and complete home and commercial property inspections.

Our 1099 Field Inspectors are the frontline experts who assist and collect data for our clients in the Property Insurance, Facility Management, and Real Estate sectors.

Essential Expectations:

+ Ability and willingness to access and inspect steep and/or high roofs

+ Lift, carry, and set up ladders and other equipment up to 100 pounds

+ Sketch and measure roof and/or room components

+ Scope the area of different sized and shaped roofs, rooms, and other inspection areas

+ Perform accurate, impartial, and complete inspections, which includes but is not limited to identification of age and condition

+ Travel to perform inspections in areas hit by weather catastrophes when needed, which includes assignments averaging two (2) to six (6) weeks at a time

+ Lodging is provided by Seek Now which can include having a fellow Seek Now Sub-Contractor as a roommate

+ Ability to take assignments on short notice and complete all aspects of job assignments as defined

+ Represent our Core Values: Self-Starter, Visionary & Strategic, Lead with Humility

+ Strong attention to detail, organization, and time management skills with a focus on professionalism and customer service

+ Document inspections using our proprietary software application on your smartphone device

+ Be comfortable covering a 100-mile radius around your home market

+ Flexible in job assignment scheduling

+ Ability to utilize other equipment as needed including 3D Cameras, Drones, Moisture meters

Preferred Qualifications:

+ Roofing sales or construction experience

+ Property Insurance experience

+ Haag Certification

+ Ability to use a 40'-foot ladder

Minimum Requirements:

+ A clean and reliable truck, van, or SUV that is capable of transporting a 32' ft ladder safely

+ An operational laptop and smartphone

+ Ability to travel, especially during catastrophic events such as hurricanes and tornadoes

+ Ability to earn HAAG Certification within 90 days

+ Ability to use a laptop and a smartphone, which includes navigating between applications, entering data, and using Microsoft Office products

+ Ability to submit complete, quality reports on time

+ 32-foot ladder

+ Professional appearance

+ Valid driver's license

+ State Issued Workers Compensation

+ Certificate of General Liability Insurance

+ LLC Articles or Certificate of Organization

+ 1099 independent contractor

+ Seek Now operates 7-days a week, providing you the opportunity to be flexible with your availability

+ Great earning potential – six figures

+ Paid weekly.

+ Team-first environment

+ State-of-the-art, technology-based tool for inspections

+ Strong support team for our 1099 independent contractor field inspectors

+ Hotel fees paid/reimbursed on CAT jobs

Other Requirements:

+ Professional appearance

+ Valid driver's license

+ State Issued Worker's Compensation

+ Certificate of General Liability Insurance

+ LLC Articles or Certificate of Organization

Position Type and Hours:

+ 1099 independent contractor

+ Seek Now operates 7-days a week, providing you the opportunity to be flexible with your availability

Benefits and Perks:

+ Great earning potential – six figures

+ Paid weekly

+ Team-first environment

+ State-of-the-art, technology-based tool for inspections

+ Strong support team for our 1099 independent contractor field inspectors

+ Hotel fees paid/reimbursed on CAT jobs

Disclaimer:

This description is not designed to cover or contain a comprehensive listing of activities, expectations, or functions that are required of the contractor.

Our Company:

Established in 2012, Seek Now captures robust property data to meet the needs of customers across the insurance and real estate industries. With more than 2 million property inspections completed to date while currently servicing 3,000 properties per day, Seek Now is the leading data capture and inspection services firm serving 240+ customers.

Our mission is to help our customers make faster decisions and improve economic outcomes, all while providing a stellar customer experience. We accomplish this through continuously reimagining how information is captured, transformed, and transmitted across all the industries we serve.

Our vision is to be the leading provider of on-demand, ground truth property data solutions. We do this while creating individual growth opportunities for our employees, expanding network of Seekers, and value add partners.

Summary:

Seek Now is searching for capable 1099 independent sub-contractors to provide accurate, impartial, and complete home and commercial property inspections.

Our 1099 Field Inspectors are the frontline experts who assist and collect data for our clients in the Property Insurance, Facility Management, and Real Estate sectors.

Essential Expectations:

+ Ability and willingness to access and inspect steep and/or high roofs

+ Lift, carry, and set up ladders and other equipment up to 100 pounds

+ Sketch and measure roof and/or room components

+ Scope the area of different sized and shaped roofs, rooms, and other inspection areas

+ Perform accurate, impartial, and complete inspections, which includes but is not limited to identification of age and condition

+ Travel to perform inspections in areas hit by weather catastrophes when needed, which includes assignments averaging two (2) to six (6) weeks at a time

+ Lodging is provided by Seek Now which can include having a fellow Seek Now Sub-Contractor as a roommate

+ Ability to take assignments on short notice and complete all aspects of job assignments as defined

+ Represent our Core Values: Self-Starter, Visionary & Strategic, Lead with Humility

+ Strong attention to detail, organization, and time management skills with a focus on professionalism and customer service

+ Document inspections using our proprietary software application on your smartphone device

+ Be comfortable covering a 100-mile radius around your home market

+ Flexible in job assignment scheduling

+ Ability to utilize other equipment as needed including 3D Cameras, Drones, Moisture meters

Preferred Qualifications:

+ Roofing sales or construction experience

+ Property Insurance experience

+ Haag Certification

+ Ability to use a 40'-foot ladder

Minimum Requirements:

+ A clean and reliable truck, van, or SUV that is capable of transporting a 32' ft ladder safely

+ An operational laptop and smartphone

+ Ability to travel, especially during catastrophic events such as hurricanes and tornadoes

+ Ability to earn HAAG Certification within 90 days

+ Ability to use a laptop and a smartphone, which includes navigating between applications, entering data, and using Microsoft Office products

+ Ability to submit complete, quality reports on time

+ 32-foot ladder

+ Professional appearance

+ Valid driver's license

+ State Issued Workers Compensation

+ Certificate of General Liability Insurance

+ LLC Articles or Certificate of Organization

+ 1099 independent contractor

+ Seek Now operates 7-days a week, providing you the opportunity to be flexible with your availability

+ Great earning potential – six figures

+ Paid weekly.

+ Team-first environment

+ State-of-the-art, technology-based tool for inspections

+ Strong support team for our 1099 independent contractor field inspectors

+ Hotel fees paid/reimbursed on CAT jobs

Other Requirements:

+ Professional appearance

+ Valid driver's license

+ State Issued Worker's Compensation

+ Certificate of General Liability Insurance

+ LLC Articles or Certificate of Organization

Position Type and Hours:

+ 1099 independent contractor

+ Seek Now operates 7-days a week, providing you the opportunity to be flexible with your availability

Benefits and Perks:

+ Great earning potential – six figures

+ Paid weekly

+ Team-first environment

+ State-of-the-art, technology-based tool for inspections

+ Strong support team for our 1099 independent contractor field inspectors

+ Hotel fees paid/reimbursed on CAT jobs

Disclaimer:

This description is not designed to cover or contain a comprehensive listing of activities, expectations, or functions that are required of the contractor.

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

**Position Summary**

+ Review provider and member claims to determine if they meet CCR review requirements.

+ Follow applicable workflows, templates, and legal and compliance requirements to provide a complete picture of what is requiring review to the CCR clinicians and medical directors.

+ Organizes and prioritizes work to help meet regulatory and CCR claim turn around times.

+ Determines coverage, verifies eligibility, benefits, identifies discrepancies, and applies all Medical Claim Management policies and procedures to assist in ensuring claims are handled per policy and legal requirements.

+ Works with all appropriate internal and external departments and personnel to accurately review specified claims and/or clarify any issues found in the course of the review.

+ Maintains and utilizes all resource materials and systems to effectively manage job responsibilities.

+ Adheres to company policies to protect member confidentiality.

**Required Qualifications**

High School Diploma or G.E.D.

**Preferred Qualifications**

+ 2+ years claim processing experience and demonstrated ability to handle multiple assignments competently, accurately and efficiently.

+ Customer service experience

+ Knowledge of Medical Terminology

**Education**

High School Diploma or G.E.D.

**Anticipated Weekly Hours**

40

**Time Type**

Full time

**Pay Range**

The typical pay range for this role is:

$18.50 - $42.35

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

**Great benefits for great people**

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

+ **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .

+ **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

+ **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 07/21/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

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.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Commercial Trucking Auto Claims Representative (PD)

**PRIMARY PURPOSE** : To analyze and process low to mid-level auto and transportation claims.

**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**

+ Processes auto property damage and lower level injury claims; assesses damage, makes payments, and ensures claim files are properly documented and correctly coded based on the policy.

+ Develops and maintains action plans to ensure state required contract deadlines are met and to move the file towards prompt and appropriate resolution.

+ Identifies and pursues subrogation opportunities; secures and disposes of salvage.

+ Communicates claim action/processing with insured, client, and agent or broker when appropriate.

+ Maintains professional client relations.

+ Performs coverage, liability, and damage analysis on all claims assignments.

**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**

+ Performs other duties as assigned.

+ Supports the organization's quality program(s).

+ Travels as required.

**QUALIFICATIONS**

**Education & Licensing**

Secure and maintain the State adjusting licenses as required for the position.

**Experience**

Three (3) years of personal line or commercial line property claims management experience or equivalent combination of education and experience required to include knowledge of construction basics. Property estimating software experience a plus.

**Skills & Knowledge**

+ Familiarity with personal and commercial lines policies and endorsements

+ Ability to review and assess Property Damage estimates, total loss evaluations, and related expenses to effectively negotiate first and third party claims.

+ Knowledge of total loss processing, State salvage forms and title requirements.

+ 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 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_ **_$55,000- $60,000_** _. 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._

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.

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.**

**Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

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.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Commercial Trucking Auto Claims Representative (PD)

**PRIMARY PURPOSE** : To analyze and process low to mid-level auto and transportation claims.

**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**

+ Processes auto property damage and lower level injury claims; assesses damage, makes payments, and ensures claim files are properly documented and correctly coded based on the policy.

+ Develops and maintains action plans to ensure state required contract deadlines are met and to move the file towards prompt and appropriate resolution.

+ Identifies and pursues subrogation opportunities; secures and disposes of salvage.

+ Communicates claim action/processing with insured, client, and agent or broker when appropriate.

+ Maintains professional client relations.

+ Performs coverage, liability, and damage analysis on all claims assignments.

**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**

+ Performs other duties as assigned.

+ Supports the organization's quality program(s).

+ Travels as required.

**QUALIFICATIONS**

**Education & Licensing**

Secure and maintain the State adjusting licenses as required for the position.

**Experience**

Three (3) years of personal line or commercial line property claims management experience or equivalent combination of education and experience required to include knowledge of construction basics. Property estimating software experience a plus.

**Skills & Knowledge**

+ Familiarity with personal and commercial lines policies and endorsements

+ Ability to review and assess Property Damage estimates, total loss evaluations, and related expenses to effectively negotiate first and third party claims.

+ Knowledge of total loss processing, State salvage forms and title requirements.

+ 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 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_ **_$55,000- $60,000_** **_._** _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._

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.

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.**

**Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

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.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Commercial Auto Claims Representative

**PRIMARY PURPOSE** : To analyze and process low to mid-level auto and transportation claims.

**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**

+ Processes auto property damage and lower level injury claims; assesses damage, makes payments, and ensures claim files are properly documented and correctly coded based on the policy.

+ Develops and maintains action plans to ensure state required contract deadlines are met and to move the file towards prompt and appropriate resolution.

+ Identifies and pursues subrogation opportunities; secures and disposes of salvage.

+ Communicates claim action/processing with insured, client, and agent or broker when appropriate.

+ Maintains professional client relations.

+ Performs coverage, liability, and damage analysis on all claims assignments.

**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. Secure and maintain the State adjusting licenses as required for the position.

**Experience**

Three (3) years of personal line or commercial line property claims management experience or equivalent combination of education and experience required to include knowledge of construction basics. Property estimating software experience a plus.

**Skills & Knowledge**

+ Familiarity with personal and commercial lines policies and endorsements

+ Ability to review and assess Property Damage estimates, total loss evaluations, and related expenses to effectively negotiate first and third party claims.

+ Knowledge of total loss processing, State salvage forms and title requirements.

+ 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 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 **$50,000- $60,000** . 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. **Always accepting applications.**

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.

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.**

**Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

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.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Claims Examiner - Workers Compensation REMOTE | California Experience

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 INDEAL CANDIDATE?** We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

**PRIMARY PURPOSE OF THE ROLE:** To analyze Workers Compensation 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.

**ESSENTIAL RESPONSIBLITIES 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.

+ Licensing / Jurisdiction Knowledge: Active adjusters license and experience handling CA workers compensation claims.

**TAKING CARE OF YOU**

+ Flexible work schedule.

+ Referral incentive program.

+ Opportunity to work in a remote or agile environment.

+ Career development and promotional growth opportunities.

+ A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

\#claimsexaminer #claims

_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_ **_($71,136 - $99,000_** **_)_** _. 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.**

**Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**