Claims Adjusters, Examiners, and Investigators

Workers Compensation Major Case Unit (MCU) Claims Specialist

109472

At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when it comes to choosing your next career move. Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work in their preferred location, while facilitating in-person connections and collaborative activities when meaningful and valuable. While the model provides a high level of flexibility and autonomy, occasional circumstances requiring in-office attendance should be expected. The candidate selected for this opportunity should be able to report into the following North American Claims office: **Schaumburg. For the right candidate who fits the role not close to primary locations offices, we will consider remote work for a candidate who is located in the U.S..**

**The ideal candidate will have experience in handling Workers Compensation claims of high exposure and complexity in one or more of these jurisdictions IA, MI, or IN.**

In this role you will be responsible for:

+ Document claim files by accurately capturing and updating claims data/information in compliance with Best Practices for Workers Compensation claims of high exposure and complexity.

+ Exercise judgment to determine compensability by gathering and analyzing relevant facts; utilizing applicable law; establishing basic principles of negligence.

+ Confirm policy verification and coverage by analyzing applicable material and determining whether the loss falls within the coverage.

+ Work to have a timely resolution to claims by developing case strategy and case evaluation, and escalating issues as appropriate.

+ Establish timely reserves and perform ongoing review throughout claims cycle within authority limit by estimating and validating value of claims.

+ Assess damages by calculating applicable exposure or range of exposure allowed by law.

+ Negotiate settlement of claim by establishing appropriate strategy and utilizing available tools and resources within authority limits.

+ Meet quality standards by following Best Practices.

Basic Qualifications:

+ Bachelor’s Degree and 6 or more years of experience in the Claims and/ or Litigation Management area.OR

+ Juris Doctor and 2 or more years of experience in the Claims and/ or Litigation Management area.OR

+ Zurich Certified Insurance Apprentice, including an Associate Degree with 6 or more years of experience in the Claims and/ or Litigation Management area.OR

+ Completion of Zurich Claims Training Program and 6 or more years of experience in the Claims and/ or Litigation Management area.OR

+ High School Diploma Equivalent and 8 or more years of experience in the Claims and/ or Litigation Management area.AND

+ Must obtain and maintain required adjuster license(s)

+ Microsoft Office experience

+ Knowledge of insurance regulations, markets and products

Preferred Qualifications:

+ Highly Preferred deep experience in handling catastrophic Workers Compensation in complexity and high exposure claims

+ Highly Preferred experience in managing WC claims in MI, IA, or IN.

+ Working with Customers

+ Customer Service skills

+ Effective verbal and written communication skills

+ Strong analytical, critical thinking and problem-solving skills

+ Strong multi-tasking and prioritization skills

+ Experience collaborating in a team environment and building cross functional working relationships

+ Proactively shares and promotes sharing of insights

+ Ability to gather unique perspectives from other teams/functions to optimize outcomes.

+ Understands, analyzes, and applies the component parts of an insurance policy for complex claims

+ Ability to follow reserving process for indemnity and expense in analyzing the potential exposure of complex claims

+ Ability to determine the scope and exposure for complex claims

+ Ability to leverage trend and relationships to provide high-quality customer service

+ Well-versed in identifying, understanding and explaining complex financial and/or actuarial trends/concepts.

+ Ability to effectively communicate coverage determinations to customers/clients/brokers for complex claims

+ Ability to direct counsel on an ongoing basis to guide the course of complex litigation and settlement strategies

Compensation for roles at Zurich varies depending on a wide array of factors including but not limited to the specific office location, role, skill set, and level of experience. As required by local law, Zurich provides in good faith a reasonable range of compensation for roles. For additional information about our Total Rewards, click here (https://www.zurichna.com/careers/benefits) . Other rewards may include short term incentive bonuses and merit increases. **Candidates with salary expectations outside of the range are encouraged to apply, and will be considered based on experience, skill, and education.** The salary provided is a nationwide market range and has not been adjusted for the applicable geographic differential associated with the location where the position may be filled.The starting salary range for this position is$71,100.00 - $116,400.00.

As a condition of employment at Zurich, employees must adhere to any COVID-related health and safety protocols in place at that time ( https://www.zurichna.com/careers/faq ).

A future with Zurich. What can go right when you apply at Zurich?

Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 150 years of experience managing risk and supporting resilience. Today, Zurich North America is a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We serve more than 25 industries, from agriculture to technology, and we insure 90% of the Fortune 500®. Our growth strategy is not limited to our business. As an employer, we strive to provide ongoing career development opportunities, and we foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our colleagues, our customers and the communities we serve. Zurich maintains a comprehensive employee benefits package for employees as well as eligible dependents and competitive compensation. Please clickhere (https://www.zurichna.com/careers) to learn more.

As a global company, Zurich recognizes the diversity of our workforce as an asset. We recruit talented people from a variety of backgrounds with unique perspectives that are truly welcome here. Taken together, diversity and inclusion bring us closer to our common goal: exceeding our customers’ expectations. Zurich does not discriminate on the basis of age, race, ethnicity, color, religion, sex, sexual orientation, gender expression, national origin, disability, protected veteran status or any other legally protected status. EOE disability/vet

Zurich does not accept unsolicited resumes from search firms or employment agencies. Any unsolicited resume will become the property of Zurich American Insurance. If you are a preferred vendor, please use our Recruiting Agency Portal for resume submission.

Location(s): AM - Schaumburg, AM - Remote Work (US)

Remote Working: Hybrid

Schedule: Full Time

Employment Sponsorship Offered: No

Linkedin Recruiter Tag: #LI-LC1 #LI-ASSOCIATE #LI-REMOTE

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having 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

Claims Examiner - Workers Compensation | AZ Jurisdiction

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.

**PREFERRED GEOGRAPHIC LOCATIONS**

Midwest & West Regions

Candidates outside of the preferred geographic regions listed above may still be considered based on level of experience.

**PRIMARY PURPOSE OF THE ROLE:** To analyze high-level 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 & experience handling AZ jurisdiction.**

**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.

_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 (_ 55,731.00 - 78,023.00 _). 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._ \#claimsexaminer #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.**

**Taking care of people is at the heart of everything we do. Caring counts**

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having 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

Claims Examiner - Workers Compensation | AZ Jurisdiction

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.

**PREFERRED GEOGRAPHIC LOCATIONS**

Midwest & West Regions

Candidates outside of the preferred geographic regions listed above may still be considered based on level of experience.

**PRIMARY PURPOSE OF THE ROLE:** To analyze high-level 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 & experience handling AZ jurisdiction.**

**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.

_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 (_ 55,731.00 - 78,023.00 _). 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._ \#claimsexaminer #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.**

**Taking care of people is at the heart of everything we do. Caring counts**

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having 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

Claims Examiner - Workers Compensation | AZ Jurisdiction

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.

**PREFERRED GEOGRAPHIC LOCATIONS**

Midwest & West Regions

Candidates outside of the preferred geographic regions listed above may still be considered based on level of experience.

**PRIMARY PURPOSE OF THE ROLE:** To analyze high-level 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 & experience handling AZ jurisdiction.**

**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.

_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 (_ 55,731.00 - 78,023.00 _). 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._ \#claimsexaminer #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.**

**Taking care of people is at the heart of everything we do. Caring counts**

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)

Claims Adjuster

Pay Rate: $38/hr

40 hours/week

Fully Remote (MST working hours)

6 month contract, possibility to extend/convert

What You'll Do:

- Identify quality opportunities by conducting file audits of partner insurance carrier claims, and may work with carrier leadership to remediate files and drive improvement through targeted file audits. (90+% of your time will be spent on this focus).

- Measure internal quality results through the review of claims submissions to our partner insurance carriers and inquiry response, and providing feedback to the Associate/Advocate team to drive improvement.

- Ensure compliance with internal and external regulatory requirements by testing key controls and providing feedback.

- Drive continuous improvement in the claim team's work by identifying training and process improvement opportunities and working with the PMO and L&D to bridge gaps.

- Collaborate across various functions to gain consensus and fix problems at the root cause.

- Partner closely with Claims Operations, Leadership and Insurance as well as key internal and external stakeholders on a variety of projects.

Basic Qualifications:

- 7+ years minimum quality assurance and/or insurance experience with focus in complex coverages and bodily injury.

- Preferred Qualifications: (job-related education, training, experience, and other criteria that are in addition to the Basic Qualifications)

- Bachelor's Degree preferred

- Experience with handling bodily injury claims at a major insurance carrier

- Ability to mentor members of the Claims team and serve as an insurance and claims subject matter expert

Performs various Customer Care Specialist activities as well as assists with special projects. As a Customer Care Support Specialist, you may be assigned to one or more of the specific jobs below and/or assist in all Specialist assignments as necessary. You will be a member of a team that provides Best in Class customer service in the Food Service industry. You will actively engage with our customers to ensure their needs are met and that their experience exceeds expectations. You will be a problem resolution expert that will partner with other cross-functional departments within the company to fulfill customer orders. Most importantly, you will see your efforts have an immediate, tangible impact every day in a well-funded and rapidly growing company.

Essential Duties:

* Order entry from internal/external customers direct or by phone and email; from non-customer sources such as fax, email and voice mail
* Customer Call Sheets and/or assignments to fulfill customer service level agreements
* Rotation of duties can vary daily/weekly, to include email communications, Inbox Management, internal and/or external customer transactions and requests
* Review reports to prevent and/or proactively make order edits and prevent lost sales
* Make product recall inquiries and timely documentation to/from customers
* Research and resolve customer delivery issues via phone and email
* Other duties may be assigned

Qualifications:

* High school diploma or General education degree (GED)
* One-year Customer Service, administrative support or restaurant experience preferred
* Must have excellent written and verbal communication skills
* Proficient in Microsoft Office suite; Word, Excel, and Outlook
* Salesforce or Customer Relationship Management (CRM) software experience preferred
* Must be flexible and willing to work the demands of the department which are subject to weekends, and holidays

Corporate Summary

At Shamrock Foods Company, people come first - our associates, our customers, and the families we serve across the nation. A privately-held, family-owned and -operated Forbes 500 company, Shamrock is an innovator in the food industry and has been since being founded in Arizona in 1922.

Our Mission

At Shamrock Foods Company, we live by our founding family's motto to "treat associates like family and customers like friends."

Why work for us?

Benefits are a major part of your overall compensation, and we believe offering them at an affordable cost is not only the right thing to do, but it helps keep you and your family healthy. That's why Shamrock Foods pays for the majority of your health insurance, allowing you to take home more of your paycheck. And it doesn't stop there - our associates also enjoy additional benefits such as 401(k) Savings Plan, Profit Sharing, Paid Time Off, as well as our incredible growth opportunities, continued education and wellness programs.

Equal Opportunity Employer

At Shamrock Foods Co all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, veteran status, sexual orientation, gender identity or any other basis protected by applicable law.

Performs various Customer Care Specialist activities as well as assists with special projects. As a Customer Care Support Specialist, you may be assigned to one or more of the specific jobs below and/or assist in all Specialist assignments as necessary. You will be a member of a team that provides Best in Class customer service in the Food Service industry. You will actively engage with our customers to ensure their needs are met and that their experience exceeds expectations. You will be a problem resolution expert that will partner with other cross-functional departments within the company to fulfill customer orders. Most importantly, you will see your efforts have an immediate, tangible impact every day in a well-funded and rapidly growing company.

Essential Duties:

* Order entry from internal/external customers direct or by phone and email; from non-customer sources such as fax, email and voice mail
* Customer Call Sheets and/or assignments to fulfill customer service level agreements
* Rotation of duties can vary daily/weekly, to include email communications, Inbox Management, internal and/or external customer transactions and requests
* Review reports to prevent and/or proactively make order edits and prevent lost sales
* Make product recall inquiries and timely documentation to/from customers
* Research and resolve customer delivery issues via phone and email
* Other duties may be assigned

Qualifications:

* High school diploma or General education degree (GED)
* One-year Customer Service, administrative support or restaurant experience preferred
* Must have excellent written and verbal communication skills
* Proficient in Microsoft Office suite; Word, Excel, and Outlook
* Salesforce or Customer Relationship Management (CRM) software experience preferred
* Must be flexible and willing to work the demands of the department which are subject to weekends, and holidays

Corporate Summary

At Shamrock Foods Company, people come first - our associates, our customers, and the families we serve across the nation. A privately-held, family-owned and -operated Forbes 500 company, Shamrock is an innovator in the food industry and has been since being founded in Arizona in 1922.

Our Mission

At Shamrock Foods Company, we live by our founding family's motto to "treat associates like family and customers like friends."

Why work for us?

Benefits are a major part of your overall compensation, and we believe offering them at an affordable cost is not only the right thing to do, but it helps keep you and your family healthy. That's why Shamrock Foods pays for the majority of your health insurance, allowing you to take home more of your paycheck. And it doesn't stop there - our associates also enjoy additional benefits such as 401(k) Savings Plan, Profit Sharing, Paid Time Off, as well as our incredible growth opportunities, continued education and wellness programs.

Equal Opportunity Employer

At Shamrock Foods Co all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, veteran status, sexual orientation, gender identity or any other basis protected by applicable law.

_Job Seekers can review the Job Applicant Privacy Policy by clicking HERE. (https://ryder.com/job-applicant-privacy-policy)\_

** FL WC Adjuster License required**

**Summary**

The Claims Representative handles complex and mid-to-high exposure bodily injury and property damage claims under Ryder's self-administered liability program. This position investigates and adjusts claims, as well as directs defense counsel, independent adjusters, experts, and other vendors in the claims-handling processes.

**Essential Functions**

+ Investigates and adjusts claims, as well as directs outside defense counsel, independent adjusters, experts, and other vendors in the claim-handling processes.

+ Supervises outside vendors retained for investigations, cost containment, expert witnesses, and litigation management to ensure claims are being handled appropriately according to the applicable jurisdiction.

+ Alerts the Claims Manager to changes and proposed changes in laws that could impact Ryder s Liability program.

+ Assists Claims Manager in the identification of exposures and recommends solutions.

+ On-going interaction with field and operations management, legal counsel, safety managers, customers, insurance carriers, and third party claimants.

+ Interacts with Law Department on significant cases, and updates field operations personnel on claims status.

+ Recommends and sets reserves to ensure the reserves represent the probable ultimate payout based on documented file developments

+ Completes detailed and quality internal reports

+ Routinely interacts with primary and excess insurance carriers, and re-insurers on file meeting reporting thresholds.

**Additional Responsibilities**

+ Performs other duties as assigned.

**Skills and Abilities**

+ Demonstrated ability to handle mid to high exposure claims

+ Ability to build strong customer relationships

+ Strong commitment to the principles of customer focus

+ Effective interpersonal skills

+ Strong verbal and written communication skills

+ Comprehensive understanding of all relevant laws and regulations as well as related medical and legal terminology

+ Requires strong claim technical skills

+ Superior negotiation skills and ability to deal effectively with claimants and plaintiff attorneys

**Qualifications**

+ Bachelor's degree required in a related field

+ Five (5) years or more experience in Casualty Claims required

**DOT Regulated:** No

Applicants from Colorado, New York. New Jersey, Connecticut and Washington State:

Salary is determined based on internal equity; internal salary ranges; market

data/ranges; applicant’s skills; prior relevant experience; certain degrees or

certifications, etc.

The salary for this position ranges from $70,000-$75,000 annually

Ryder offers comprehensive health and welfare benefits, to include medical,

prescription, dental, vision, life insurance and disability insurance options, as well as

paid time off for vacation, illness, bereavement, family and parental leave, and a tax advantaged 401(k) retirement savings plan

**Job Category:** Risk Management

Ryder is proud to be an Equal Opportunity Employer and Drug Free workplace. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, among other things, or status as a qualified individual with disability.

_Job Seekers can review the Job Applicant Privacy Policy by clicking HERE. (https://ryder.com/job-applicant-privacy-policy)\_

**Current Employees:**

If you are a current employee at Ryder (not a Contractor or temporary employee through a staffing agency), please click here (http://wd5.myworkday.com/ryder/d/task/1422$3.htmld) to log in to Workday to apply using the internal application process.

\#wd

**Overview**

**About Public Consulting Group**

Public Consulting Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, PCG employs approximately 2,000 professionals throughout the U.S.—all committed to delivering solutions that change lives for the better. The firm is a member of a family of companies with experience in all 50 states, clients in six Canadian provinces and Europe. PCG offers clients a multidisciplinary approach to meet challenges, pursue opportunities, and serve constituents across the public sector. To learn more, visit www.publicconsultinggroup.com .

**Responsibilities**

Reviews claims for irregularities, accuracy and completeness.

Requests additional information, where necessary, for completion of claim processing.

Reviews claims for eligibility.

Maintains updated records and prepares required reports.

Assists in claims cost control.

Contacts individuals about claims and may provide counsel regarding the amount of benefits.

Performs work under general supervision.

Handles moderately complex issues and problems, and refers more complex issues to higher-level staff.

Possesses solid working knowledge of subject matter.

**Qualifications**

· Ability to evaluate, coordinate and perform a complex set of planning, development and administrative

tasks.

· Ability to build and maintain working relationships with federal, state and county agency staff.

· Strong Microsoft application skills.

· Ability to work with a large volume of claims and effectively prioritize the workload.

· Excellent organizational, oral presentation and written communication skills.

· Strong analytical skills, including the ability to analyze and organize data.

· Ability to work both in a team situation and autonomously.

· Existing knowledge or experience with state government, health insurance payment systems

(particularly Medicaid), and/or cost accounting are highly advantageous.

· Knowledge and understanding of appropriate laws and regulations and applicable government

agencies

High School Diploma or equivalent is required. A Bachelor’s Degree is preferred

4+yrs experience

**Remote Work Statement**

This position is a remote, work from home position. PCG is a remote-friendly organization and is committed to creating a culture where remote work remains a vital part of the company’s success. To be successful in a remote work role at PCG, you must:

+ be available during your set working hours

+ have a safe, private, and distraction-free environment in which to complete your work, and

+ be able to give your full attention to the completion of your PCG job duties

Some travel to the office or elsewhere may be required for team meetings, client meetings, etc.

\#LI-MB1

\#LI- Remote

**Compensation**

Compensation for roles at Public Consulting Group varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, PCG provides the following reasonable range of compensation for this role: $60,000-72,000. In addition, PCG provides a range of benefits for this role.

**EEO Statement**

Public Consulting Group is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PCG, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PCG will not tolerate discrimination or harassment based on any of these characteristics. PCG believes in health, equality, and prosperity for everyone so we can succeed in changing the ways the public sector, including health, education, technology and human services industries, work.

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**Job Locations** _US_

**Posted Date** _12 hours ago_ _(12/6/2023 5:01 PM)_

**_Job ID_** _2023-9984_

**_\# of Openings_** _8_

**_Category_** _Customer Service/Support_

**_Type_** _Regular Full-Time_

**_Practice Area_** _Human Services_

Public Consulting Group is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity, protected veteran status, or status as a qualified individual with a disability. VEVRAA Federal Contractor.

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having 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

Claims Examiner - Workers Compensation | AZ/CO/UT Jurisdictions

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.

**PREFERRED GEOGRAPHIC LOCATIONS**

Midwest & West regions preferred.

Candidates outside of the preferred geographic regions listed above may still be considered based on level of experience.

**PRIMARY PURPOSE OF THE ROLE:** To analyze high-level 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 AZ/CO/UT jurisdictions.**

**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.

_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 (_ 61,599.00 - 86,238.00 _). 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._ \#claimsexaminer #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.**

**Taking care of people is at the heart of everything we do. Caring counts**

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)