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 Adjuster PRIMARY PURPOSE: Handles losses and claims valued up to $15,000 for property and casualty insurers through the thorough examination of documents, records, loss reports, and other relevant documentation. Efficiently manages a case load using technology for efficient claim processing. ESSENTIAL FUNCTIONS and RESPONSIBILITIES - Evaluates insurance policies, claims forms, policies, endorsements, carrier instructions, and other records to determine insurance coverage. - Conducts thorough investigations, gathers official reports as needed, consults police and hospital records and inspects physical damage or written estimates for damages based on a conducted inspection to determine extent of company's liability and varying methods of investigation, according to type of insurance. - Interviews, telephones, and/or corresponds with claimant and witnesses regarding claim. - Estimates cost of repair, replacement, or compensation. - Prepares report of findings and negotiates claim settlements by adhering to carrier instructions and obtaining necessary information. Issues settlement checks, files regulatory documents, and handles salvage and subrogation as applicable. - Recommends litigation by legal department when settlement cannot be negotiated. - Attends litigation hearings and participates in depositions as necessary. - Revises case reserves in assigned claims files to cover probable costs. - Maintains an expected caseload efficiently. - Utilizes technology and automation tools for efficient claim handling. - Sends claims exceeding $15,000 gross loss amount to leadership for authority approval. ADDITIONAL FUNCTIONS and RESPONSIBILITIES - Performs other duties as assigned. QUALIFICATIONS Education & Licensing Bachelor's degree from an accredited college or university preferred. Must obtain IIA-AIC designation within 12 to 18 months in the role. Appropriate state adjuster license is required. Experience Three (3) year of related experience or equivalent combination of education and experience required. Prior experience handling property and casualty claims a plus but not required. Skills & Knowledge - Empathetic claims handling demeanor - Strong communication, analytical, organizational, and interpersonal skills - PC literate, including Microsoft Office products - Analytical and interpretive skills - Negotiating skills - Ability to create and complete comprehensive, accurate and constructive written reports - Ability to work in a team environment - Ability to meet or exceed Performance Competencies WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, 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 The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Overview Being good neighbors – helping people, investing in our communities, and making the world a better place – is who we are at State Farm. It is at the core of how we operate and the reason for our success. Come join a #1 team and do some good! Grow Your Skills, Grow Your Potential Responsibilities Join our team as a Property Field Inspection Claim Specialist and showcase your expertise in handling accident and weather-related claims for homeowners, commercial properties, and large losses. We are looking for an experienced and highly skilled professional to contribute to our dynamic team. You will be the first point of contact to meet with our insureds, explain coverage, estimate damages, and help them through the claims process while providing Remarkable service. Key Responsibilities: - Conduct on-site inspections and assessments of property damages for both residential and commercial claims - Collaborate with policyholders, insurance agents, and other involved parties to gather information and resolve claims efficiently - May occasionally require interacting with parties who express strong emotions or concerns about ongoing inspections or claim resolutions - Provide exceptional customer service throughout the claims process, addressing inquiries and concerns promptly and professionally - Gather necessary evidence, document findings, and prepare detailed reports to support the claims handling process - Investigate and adjust both personal and commercial property claims with exposures up to $500,000 - Evaluate coverage and policy terms to determine the validity of claims and ensure compliance with local regulations - Negotiate and settle claims within the authorized limits, considering policy provisions, industry standards, and company guidelines Where you'll work: This position is located in Swedesboro, NJ. Competitive candidates should reside within one of the listed zip codes and will service this same territory: 08001 08014 08020 08027 08028 08032 08038 08039 08051 08056 08061 08062 08066 08067 08069 08070 08071 08072 08079 08080 08085 08090 08094 08097 08098 08310 08312 08318 08322 08326 08328 08341 08343 08344 08360. This is a Remote-Field position in which you will work from home and utilize a mobile office/vehicle for in-person appointments. Although the primary work location is in the field, with a commutable distance from home, there will be opportunities for virtual work to be completed at home. Additionally, there may be occasions where you will be required to travel outside your assigned area to assist in other territories. Hours of operation are continually evaluated and may change based on business need. Successful candidates are able and willing to work flexible schedules and may be asked to work overtime and/or irregular hours. Qualifications Competitive candidates must demonstrate: - Experience as a Property Field Inspection Claim Specialist in the insurance industry, specifically in property claims - Strong knowledge of property insurance policies, coverage and claim handling practices - Knowledge of both residential and commercial building construction - Familiarity with local regulations and compliance requirements in your assigned territory - Excellent communication and interpersonal skills to effectively interact with clients, agents, and other stakeholders - Proven effective communication skills to handle difficult/emotional conversations with a customer-minded focus - Proven ability to assess damages, estimate repair costs, and negotiate settlements - Detail-oriented with strong organizational and analytical skills - Proficient in using claims management software and other relevant tools - Physical agility to allow for: frequent lifting, carrying and climbing a ladder; ability to navigate roofs at various heights for inspection of both residential and commercial structures; ability to crawl in tight spaces - May be required to complete Rope and Harness Safety Training. - A valid driver's license is required Preferred: - Bachelor's Degree in a related field or equivalent work experience - Experience in handling complex or high-value claims - Construction background - Water mitigation inspection experience - Xactimate, XactContents Additional Details: - Employees must successfully complete all required training, including applicable licensing exam(s), Motor Vehicle Record (MVR) checks, and background checks required of various state(s). - State Farm recently implemented new pre-employment assessments. Candidates that have previously taken an assessment may be asked to participate in additional testing Our Benefits Because work-life balance is a priority at State Farm, compensation is based on our standard 38:45-hour work week! - Potential starting salary range: $64,965.62 - $99,000.00 annually - Starting salary will be based on skills, background, and experience - High end of the range limited to applicants with significant relevant experience - Potential yearly incentive pay up to 15% of base salary At State Farm, we offer more than just a paycheck. Check out our suite of benefits designed to give you the flexibility you need to take care of you and your family! - Get Paid! On top of our competitive pay, you are eligible for an annual raise and bonus. - Stay Well! Focus on you and your family’s health with our robust health and wellbeing programs. State Farm pays most of your healthcare premium, and we offer multiple healthcare plan options, including a high deductible plan. All medical plans provide 100% coverage for in-network preventative care, AND you and your family have access to vision, dental, telemedicine, 24/7 mental health professionals, and much more! - Develop and Grow! Take advantage of educational benefits like industry leading training programs, top-notch tuition assistance programs, employee resource groups, and mentoring. - Plan Ahead! Plan for those big moments in life with benefits like fertility/IVF/adoption assistance, college coaching, national discount programs, interactive monthly financial workshops, free financial coaching, and more. You can also start a savings account or consider financing through our State Farm Federal Credit Union! - Take a Little “You” Time! You will have access to our generous time off policies designed so you can plan around holidays, family events, volunteering, or just to take a relaxing day off. With the opportunity to initially earn up to 20 days annually plus parental leave, paid holidays, celebration day, life leave (40 hours/year), bereavement leave, and community service/education support days, there will be plenty of time for you! - Give Back! We offer several ways to give back through our Matching Gift Program, Good Neighbor Grant Program, and the Employee Assistance Fund. - Finish Strong! Plan for retirement using free financial advisors and a 401(k) plan with company contributions of up to 7% of your salary. Visit our State Farm Careers page for more information on our benefits, locations, and the hiring process of joining the State Farm team!

Overview Being good neighbors – helping people, investing in our communities, and making the world a better place – is who we are at State Farm. It is at the core of how we operate and the reason for our success. Come join a #1 team and do some good! Grow Your Skills, Grow Your Potential Responsibilities Join our team as a Property Field Inspection Claim Specialist and showcase your expertise in handling accident and weather-related claims for homeowners, commercial properties, and large losses. We are looking for an experienced and highly skilled professional to contribute to our dynamic team. You will be the first point of contact to meet with our insureds, explain coverage, estimate damages, and help them through the claims process while providing Remarkable service. Key Responsibilities: - Conduct on-site inspections and assessments of property damages for both residential and commercial claims - Collaborate with policyholders, insurance agents, and other involved parties to gather information and resolve claims efficiently - May occasionally require interacting with parties who express strong emotions or concerns about ongoing inspections or claim resolutions - Provide exceptional customer service throughout the claims process, addressing inquiries and concerns promptly and professionally - Gather necessary evidence, document findings, and prepare detailed reports to support the claims handling process - Investigate and adjust both personal and commercial property claims with exposures up to $500,000 - Evaluate coverage and policy terms to determine the validity of claims and ensure compliance with local regulations - Negotiate and settle claims within the authorized limits, considering policy provisions, industry standards, and company guidelines Where you'll work: This position is located in Newark, NJ. Competitive candidates should reside within one of the listed zip codes and will service this same territory: 07003 07008 07009 07011 07012 07013 07014 07016 07017 07018 07028 07033 07036 07040 07041 07042 07043 07044 07050 07052 07055 07065 07079 07083 07088 07102 07103 07104 07105 07106 07107 07108 07109 07110 07111 07112 07114 07201 07202 07203 07204 07205 07206 07208 07424 07503 07512 07513. This is a Remote-Field position in which you will work from home and utilize a mobile office/vehicle for in-person appointments. Although the primary work location is in the field, with a commutable distance from home, there will be opportunities for virtual work to be completed at home. Additionally, there may be occasions where you will be required to travel outside your assigned area to assist in other territories. Hours of operation are continually evaluated and may change based on business need. Successful candidates are able and willing to work flexible schedules and may be asked to work overtime and/or irregular hours. Qualifications Competitive candidates must demonstrate: - Experience as a Property Field Inspection Claim Specialist in the insurance industry, specifically in property claims - Strong knowledge of property insurance policies, coverage and claim handling practices - Knowledge of both residential and commercial building construction - Familiarity with local regulations and compliance requirements in your assigned territory - Excellent communication and interpersonal skills to effectively interact with clients, agents, and other stakeholders - Proven effective communication skills to handle difficult/emotional conversations with a customer-minded focus - Proven ability to assess damages, estimate repair costs, and negotiate settlements - Detail-oriented with strong organizational and analytical skills - Proficient in using claims management software and other relevant tools - Physical agility to allow for: frequent lifting, carrying and climbing a ladder; ability to navigate roofs at various heights for inspection of both residential and commercial structures; ability to crawl in tight spaces - May be required to complete Rope and Harness Safety Training. - A valid driver's license is required Preferred: - Bachelor's Degree in a related field or equivalent work experience - Experience in handling complex or high-value claims - Construction background - Water mitigation inspection experience - Xactimate, XactContents Additional Details: - Employees must successfully complete all required training, including applicable licensing exam(s), Motor Vehicle Record (MVR) checks, and background checks required of various state(s). - State Farm recently implemented new pre-employment assessments. Candidates that have previously taken an assessment may be asked to participate in additional testing Our Benefits Because work-life balance is a priority at State Farm, compensation is based on our standard 38:45-hour work week! - Potential starting salary range: $73,824.56 - $112,500.00 annually - Starting salary will be based on skills, background, and experience - High end of the range limited to applicants with significant relevant experience - Potential yearly incentive pay up to 15% of base salary At State Farm, we offer more than just a paycheck. Check out our suite of benefits designed to give you the flexibility you need to take care of you and your family! - Get Paid! On top of our competitive pay, you are eligible for an annual raise and bonus. - Stay Well! Focus on you and your family’s health with our robust health and wellbeing programs. State Farm pays most of your healthcare premium, and we offer multiple healthcare plan options, including a high deductible plan. All medical plans provide 100% coverage for in-network preventative care, AND you and your family have access to vision, dental, telemedicine, 24/7 mental health professionals, and much more! - Develop and Grow! Take advantage of educational benefits like industry leading training programs, top-notch tuition assistance programs, employee resource groups, and mentoring. - Plan Ahead! Plan for those big moments in life with benefits like fertility/IVF/adoption assistance, college coaching, national discount programs, interactive monthly financial workshops, free financial coaching, and more. You can also start a savings account or consider financing through our State Farm Federal Credit Union! - Take a Little “You” Time! You will have access to our generous time off policies designed so you can plan around holidays, family events, volunteering, or just to take a relaxing day off. With the opportunity to initially earn up to 20 days annually plus parental leave, paid holidays, celebration day, life leave (40 hours/year), bereavement leave, and community service/education support days, there will be plenty of time for you! - Give Back! We offer several ways to give back through our Matching Gift Program, Good Neighbor Grant Program, and the Employee Assistance Fund. - Finish Strong! Plan for retirement using free financial advisors and a 401(k) plan with company contributions of up to 7% of your salary. Visit our State Farm Careers page for more information on our benefits, locations, and the hiring process of joining the State Farm team!

Site: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. This role supports the quality control of claims entry and processing to identify claims processing errors and remediation prior to payment or denial. Job Summary Responsible for monitoring Quality Control (QC) of Claims Operations and the reporting of all metrics related to such activities. Essential Functions - Responsible for end-to-end pre-pay review of claims adjudicated in QNXT to ensure complete and accurate claims processing in alignment with Medicare regulations, including but not limited to accuracy for paper claim entry, application of benefits and cost-share, CCI/NCCI edits, authorizations, rate of payment, attributes, decision codes, and memos leading to identification of issues which require remediation prior to the weekly check run. -Includes the post-pay review of Explanations of Payments to providers, as well as calculation and accumulation of MOOP, interest, sequestration, etc. -Perform trend analysis and root cause review analysis. -Responsible to ensure claims processing entry and adjudication accuracy -Responsible for identifying potential areas of compliance vulnerability and risk and working with department supervisors/managers to develop and implement remediation plans and/or corrective action as needed and recommend appropriate solutions to enhance current quality assurance programs. -Develop and implement new quality control processes, assist in the business testing process, and participate in projects. -Completion of post-payment Claims Monthly Compliance Monitoring review which is delivered to senior leadership Qualifications Education - Bachelor's Degree preferred Experience - At least 2-3 years of quality control experience within medical claims required - At least 2-3 years of healthcare experience required - At least 2-3 years of Medicare Advantage medical claims processing experience required - At least 2-3 years of MassHealth (Medicaid) medical claims processing experience highly preferred - AAPC certification(s) a plus Knowledge, Skills and Abilities - Experience in monitoring, measuring and reporting on quality and productivity of medical claims processing. - Strong analytical abilities to assess risks, analyze data, and make informed recommendations for improvement. - Excellent written and verbal communication skills to prepare reports, deliver training sessions and collaborate effectively with multifaceted teams across different specialties. - Ability to understand claims processing edits, correct coding edits, medically unlikely edits Additional Job Details (if applicable) Working Conditions - This is a remote role that can be done from most US states - Employees must use a stable, secure, and compliant workstation in a quiet environment. Teams video is required and must be accessed using MGB-provided equipment. - This is a Monday through Friday role with a schedule of either 8:00 AM - 4:30 PM EDT or 8:30 AM - 5:00 PM EDT. Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $25.50 - $36.49/Hourly Grade 5 At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: 8925 Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.