NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team. In this Role the candidate will be responsible for: • Processing of Professional claim forms files by provider • Reviewing the policies and benefits • Comply with company regulations regarding HIPAA, confidentiality, and PHI • Abide with the timelines to complete compliance training of NTT Data/Client • Work independently to research, review and act on the claims • Prioritize work and adjudicate claims as per turnaround time/SLAs • Ensure claims are adjudicated as per clients defined workflows, guidelines • Sustaining and meeting the client productivity/quality targets to avoid penalties • Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA. • Timely response and resolution of claims received via emails as priority work • Correctly calculate claims payable amount using applicable methodology/ fee schedule Requirements: • 3 year(s) hands-on experience in Healthcare Claims Processing • 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools • High school diploma or GED. • Previously performing – in P&Q work environment; work from queue; remotely • Key board skills and computer familiarity – o Toggling back and forth between screens/can you navigate multiple systems. o Working knowledge of MS office products – Outlook, MS Word and MS-Excel. Preferred Skills & Experiences: • Amisys • Ability to communicate (oral/written) effectively in a professional office setting • Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities • Time management with the ability to cope in a complex, changing environment

The Material Damage Claims Specialist (MDS) is primarily responsible for the timely completion of internal estimates, appraisals, and valuations for the REPO Plus department. They serve as the physical damage experts/SMEs within the department and will routinely complete audits of outside insurance carrier (OIC) estimates/appraisals. Additionally, they are tasked with both initial and evergreen training related to automobile physical damage. Job Duties and Responsibilities:​ Physical Damage Estimate/Appraisal Production - Will complete internal estimates, appraisals, and valuations on REPO Plus claim files. - This may include desk estimates of damaged vehicles, total loss valuations, and reviews or audit of externally supplied material. - Work is generated from internal REPO Plus claim files as well as via request from lender clients. - Required to meet production goals set by REPO Plus management. - Required to meet QA goals set by REPO Plus management. Physical Damage Subject Matter Expert - Will field questions and provide answers to REPO Plus Adjusters and Analysts as needed such as: - Estimate Review - Total Loss valuations audit - Written responses to OIC appraisers - Will be involved in all testing necessary to validate new workflows/processes and system integrations or applications within the REPO Plus department (ex. Integrating the CCC platform with PEGA for REPO Plus). Physical Damage Training - Provide initial physical damage training for the REPO Plus department including the following: - Condition Report review training for incoming REPO Plus Processors - Physical damage/Estimate training for incoming REPO Plus Adjusters and Analysts - Evergreen training related to physical damage including updates to state regulations, industry standards, etc. Qualifications (Education, Experience, Certifications & KSA): - High school diploma or GED. - 8-10 years of work-related experience. - Required to maintain all applicable licensing (if required) and continuing education/training necessary to complete the above work in all 50 states. This may include: - State licensing - Training specific to changes within the automobile physical damage field (ICAR, etc.) The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with a job. #LI-SJ1 #LI-Remote We offer our employees a robust compensation package! Our comprehensive benefits include: medical, dental and vision insurance coverage; 100% company-paid life and disability coverage, 401k options with company match, three weeks PTO by the end of the first year and much more. Allied proudly promotes from within as part of a strong commitment to providing career growth opportunities for employees of all levels. Our diverse business portfolio allows employees broad career options with the advantage of staying with the same organization. All qualified candidates will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, or any other characteristic protected by law. To view our privacy statement click here To view our terms and conditions click here

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 Comp PRIMARY PURPOSE: To analyze complex or technically difficult workers compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; and to ensure ongoing adjudication of claims within company standards and industry best practices or client specific requirements. ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work. ESSENTIAL FUNCTIONS and RESPONSIBILITIES - Analyzes and processes complex or technically difficult claims by investigating and gathering information to assist employer in determining their position on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. - Works to move claim towards appropriate claim closure which may include referral for settlement evaluation. - Monitors reserve adequacy throughout the life of the claim if applicable. - Monitors and reviews benefits due and payment calculations ensuring accuracy. - Prepares necessary state filings within statutory limits. - Follows best practice standards in contested claims including outside legal representation. - Coordinates vendor referrals for additional investigation and/or litigation management. - Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients. - Participates in claim recoveries including, but not limited to: subrogation, Second Injury Fund recoveries, and Social Security offsets. - Communicates claim action/processing with appropriate parties including, but not limited to: claimant, client, state agency, managed care organization and appropriate medical contact. - Ensures claims files are properly documented and claims coding is correct. - Maintains professional client relationships. - Coordinates actuarial/settlement issues impacting employers with rate and settlement departments. - Assesses policy level status of clients; works in coordination with clients' service expectations and assigned service personnel. QUALIFICATIONS Education & Licensing Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certification as applicable to line-of-business preferred. Experience Four (4) years claims management experience or equivalent combination of education and experience required. Skills & Knowledge - In-depth line-of-business knowledge of appropriate insurance principles and laws, recoveries offsets and deductions, and cost containment principles - Excellent oral and written communication skills, 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 Performance Competencies - Supports the organization's quality program(s). - Performs other duties as assigned. WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations. TAKING CARE OF YOU BY - We offer a diverse and comprehensive benefits package including: - Three Medical, and two dental plans to choose from. - Tuition reimbursement eligible. - 401K plan that matches 50% on every $ you put in up to the first 6% you save. - 4 weeks PTO your first full year. NEXT STEPS If your application is selected to advance to the next round, a recruiter will be in touch. 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 $47,000 - $50,000. 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.

Overview Workers’ Compensation Claim Specialist Location: Remote (Reporting to Scottsdale, AZ Branch)Schedule: Monday–Friday, 8:00 AM–4:30 PM MSTSalary Range: $85,000–$96,000 annually (Depending on experience) Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don’t just process claims—we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work®, and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. Job Summary We are looking for an experienced Workers’ Compensation Claim Specialist to join our remote team supporting multiple California jurisdiction PEO accounts. At CCMSI, we hire professionals who show strong judgment, ownership, and pride in their work—people who understand that accuracy, empathy, and consistency are the foundation of exceptional claim handling. In this role, you’ll be trusted to manage your files independently while contributing to a larger team focused on service excellence, compliance, and client partnership. This position offers the stability of dedicated clients, manageable caseloads, and regular collaboration with a team of seasoned WC professionals. A one-week, in-person onboarding and connection session at our Scottsdale office is available to help you integrate seamlessly into the team. Please note: This is not an HR, administrative, consulting, or advisory support role. This is a true adjusting position. Candidates must have proven experience conducting full investigation, evaluation, negotiation, and resolution of workers’ compensation claims, with end-to-end file ownership and decision-making authority. Applicants without direct claims adjusting experience will not be considered. Responsibilities At CCMSI, we hire individuals who take ownership, ask the right questions, and stay ahead of the work. Your ability to organize, prioritize, and resume tasks seamlessly is essential for success. • Investigate, evaluate, and adjust California workers’ compensation claims in compliance with state regulations, CCMSI handling standards, and client instructions.• Establish and maintain accurate reserves and thorough documentation within assigned authority levels.• Review, authorize, and process medical, legal, and indemnity payments.• Negotiate claim settlements aligned with jurisdictional guidelines and industry best practices.• Maintain consistent, professional communication with clients, claimants, attorneys, and providers.• Participate in claim reviews, quality audits, and team discussions to support consistency and compliance.• Deliver excellent client service through timely, detailed, and thoughtful claim handling. Qualifications Required: - Minimum of 10 years of workers’ compensation claim adjusting experience. - Proficiency in Microsoft Office (Word, Excel, Outlook). - Strong written and verbal communication skills. - Proven ability to manage deadlines and multiple priorities effectively. - California jurisdiction experience required. Preferred: - California SIP certification. - Claim review presentation experience. - AIC, ARM, or CPCU designation. How We Measure Success - Internal audit results and compliance metrics. - Annual performance reviews. - Timeliness, accuracy, and client satisfaction outcomes. Why You’ll Love Working Here - 4 weeks PTO + 10 paid holidays in your first year - Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance - Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) - Career growth: Internal training and advancement opportunities - Culture: A supportive, team-based work environment Compensation & Compliance The posted salary reflects CCMSI’s good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position.ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process.Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations. Our Core Values At CCMSI, we believe in doing what’s right—for our clients, our coworkers, and ourselves. We look for team members who: - Lead with transparency We build trust by being open and listening intently in every interaction. - Perform with integrity We choose the right path, even when it is hard. - Chase excellence We set the bar high and measure our success. What gets measured gets done. - Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. - Win together Our greatest victories come when our clients succeed. We don’t just work together—we grow together. If that sounds like your kind of workplace, we’d love to meet you. #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #WorkersCompensation #ClaimsAdjuster #RemoteJobs #CaliforniaJobs #InsuranceCareers #TransportationIndustry #LI-Remote