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 Sr. Claims Specialist, Professional Liability | Medical Malpractice (Long Term Care) | Florida PRIMARY PURPOSE: To analyze complex or technically difficult medical malpractice claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within Company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service. ESSENTIAL FUNCTIONS and RESPONSIBILITIES - Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. - Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions. - Negotiates claim settlement up to designated authority level. - Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life. - Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement. - Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines. - Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients. - Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost. - Represents Company in depositions, mediations, and trial monitoring as needed. - Communicates claim activity and processing with the client; maintains professional client relationships. - Ensures claim files are properly documented and claims coding is correct. - Refers cases as appropriate to supervisor and management. - Delegates work and mentors assigned staff. ADDITIONAL FUNCTIONS and RESPONSIBILITIES - Performs other duties as assigned. - Supports the organization's quality program(s). 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 Six (6) years of claims management experience or equivalent combination of education and experience required. Skills & Knowledge - In-depth knowledge of appropriate medical malpractice insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as applicable to line-of-business - Excellent oral and written communication, including presentation skills - PC literate, including Microsoft Office products - Analytical and interpretive skills - Strong organizational skills - Excellent negotiation skills - Good interpersonal skills - 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.

Introduction At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it’s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives. It takes empathy, precision, and a strong sense of partnership—and that’s exactly what you’ll find here. We’re a team of fast-paced fixers, empathetic experts, and outcomes drivers — people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence. Here, you’ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you’re here, you’re part of something bigger. You’re part of a team that shows up, stands together, and leads with purpose. Overview Role specifics: - Jurisdictions: - Licenses: - Location: This role is eligible for fully remote work. How you'll make an impact - Apply claims management experience to execute decision-making to analyze claims exposure, plan the proper course of action, and appropriately resolve claims. - Interact extensively with various parties involved in the claim process to ensure effective communication and resolution. - Provide exceptional customer service to our claimants on behalf of our clients exhibiting empathy through each step of the claims process - Handle claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethics requirements. - Document and communicate claim activity timely and efficiently, supporting the outcome of the claim file. About You Ideal candidates for this position will have: - Claims Background: workers compensation lost time/indemnity - Jurisdictional Experience: - Active Adjusters' licenses: As a key member of our experienced Claims Adjuster team, you will: - Investigate, evaluate, and resolve complex workers compensation claims applying your analytical skills to make informed decisions and bring claims to resolution. - Work in partnership with our clients to deliver innovative solutions and enhance the claims management process - Think critically, solve problems, plan, and prioritize tasks to optimally serve clients and claimants Required Qualifications: - High School Diploma. - Minimum of 5 years related claims experience. - Appropriately licensed and/or certified in all states in which claims are being handled. - Knowledge of accepted industry standards and practices. - Computer experience with related claims and business software. Desired: - Bachelor's Degree #LI-KQ1 #LI-REMOTE Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you’ll get, depending on your job level these benefits may improve: - Medical/dental/vision plans, which start from day one! - Life and accident insurance - 401(K) and Roth options - Tax-advantaged accounts (HSA, FSA) - Educational expense reimbursement - Paid parental leave Other benefits include: - Digital mental health services (Talkspace) - Flexible work hours (availability varies by office and job function) - Training programs - Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing - Charitable matching gift program - And more... **The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process. We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as “protected characteristics”) by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.

Role Description Due to growth, we are adding a Supervisor, Claims Quality Testing to our team. The Supervisor, Claims Quality Testing oversees quality regression testing and pre-implementation audit processes, providing leadership and direction to a team of quality testing professionals. This role is responsible for ensuring testing activities are accurate, compliant, and aligned with business, client, and regulatory requirements. The Supervisor collaborates closely with internal and external partners to support effective issue resolution and drive continuous improvements in testing practices. This role requires strong management capabilities along with experience in benefit testing across PBM lines of business, preventative action planning, process improvements, and client-facing communication. Responsibilities - Provide leadership, oversight, and direction to a team of quality testing professionals supporting analysis and auditing processes. - Coach, mentor, and develop direct reports to ensure high performance, accountability, and professional growth. - Assign, prioritize, and manage quality testing workloads to meet project timelines and business objectives. - Oversee quality testing activities across PBM functions, including claims adjudication, eligibility, formulary, pricing, accumulators, and benefit configuration from a regression and/or pre-implementation audit perspective. - Ensure test plans, test cases, and execution are comprehensive, risk-based, and aligned with business, client, and regulatory requirements. - Review and approve testing documentation and results to ensure accuracy, completeness, and consistency. - Oversee the identification, documentation, tracking, and resolution of discrepancies and quality issues identified during testing. - Partner with technology, configuration, operations, and business stakeholders to ensure timely and effective issue resolution. - Lead and support root cause analyses (RCA) for testing discrepancies, production issues, and quality trends. - Develop, implement, and monitor corrective and preventative action plans to reduce repeat issues. - Communicate testing outcomes, quality findings, and risk assessments to internal stakeholders and client-facing teams. - Escalate critical or high-risk testing issues in accordance with established governance and reporting protocols. - Other duties as assigned. Qualifications - Bachelor’s degree or equivalent work experience is required. - 3+ years leading a team responsible for quality or benefit testing specifically in a PBM environment. - Proven experience in leadership and team management. - Knowledge of regulatory requirements and industry standards applicable to PBM testing and quality activities. - Participate in, adhere to, and support compliance program objectives. - The ability to consistently interact cooperatively and respectfully with other employees. Benefits - Top of the industry benefits for Health, Dental, and Vision insurance. - 20 days paid time off. - 4 weeks paid parental leave. - 9 paid holidays. - 401K company match of up to 5% - No vesting requirement. - Adoption Assistance Program. - Flexible Spending Account. - Educational Assistance Plan and Professional Membership assistance. - Referral Bonus Program – up to $750!

Salary Range: $80,000 - $110,000 Job Posting End Date: March 27th 2026 We’ve Got You Under Our Wing We are the duck. We develop and empower our people, cultivate relationships, give back to our community, and celebrate every success along the way. We do it all…The Aflac Way. Aflac, a Fortune 500 company, is an industry leader in voluntary insurance products that pay cash directly to policyholders and one of America's best-known brands. Aflac has been recognized as Fortune’s 50 Best Workplaces for Diversity and as one of World’s Most Ethical Companies by Ethisphere.com. Our business is about being there for people in need. So, ask yourself, are you the duck? If so, there’s a home, and a flourishing career for you at Aflac. Worker Designation – This role is a remote role. This means you will be expected to work from your home, within the continental US. If the role is remote, there may be occasions that you are requested to come to the office based on business need. Any requests to come to the office would be communicated with you in advance. What does it take to be successful at Aflac? - Acting as a Champion for Change - Acting with Integrity - Communicating Effectively - Demonstrating Initiative - Developing Talent - Managing Performance - Pursuing Self-Development - Serving Customers - Supporting Change - Supporting Organizational Goals - Working with Diverse Populations What does it take to be successful in this role? • Broad knowledge of production management concepts, operating principles, and operational management methodology applicable to claims processing; a high degree of skill in applying this knowledge to the analysis and resolution of very complex or sensitive claims operational issues; ability to apply new developments and methodologies to direct the improvement in efficiencies • Broad knowledge of federal, state, and local regulatory and industry requirements, standard concepts, practices, and procedures as they relate to the insurance industry and claims processing • Knowledge of budgeting and expense control to plan, implement, and maximize expenditure of funds while maintaining and improving quality standards • Knowledge of employee relations to conduct and deal with employee issues in a proactive manner • Strong personal computer skills with experience in Windows-based software; experience using Microsoft Outlook or a similar e-mail system software • Excellent presentation, oral, written, and interpersonal communications skills to effectively interact with senior management, and internal and external business contacts Education & Experience Required - Bachelor's Degree In business or a related field - 6 years of job-related work experience. - 4 years in a leadership/senior/supervisory capacity. Or an equivalent combination of education and experience Education & Experience Preferred - Absence & Disability Industry Experience (STD/FMLA) - Industry designations such as FLMI or ALHC. Principal Duties & Responsibilities • Manages the daily operations of the Claims business unit; manages employees and operations of the business unit at the functional level; gathers and analyzes data and reports that pertain to the overall operation of the Claims business unit and completes reports summarizing activities and trends; assists in strategic and tactical operational plans to ensure achievement of company and departmental goals; performs independent review of problem situations; develops solutions and implements actions to resolve problems and ensure customer satisfaction; reviews processes and procedures to streamline activities to enhance service turnaround time, productivity, and quality; coordinates overall workflow of the business unit and ensures that workflow processes facilitate effective and efficient use of corporate resources and enhance customer satisfaction • Directs efforts to implement risk management and quality improvement initiatives; facilitates calibration sessions; uses methods such as work process studies, statistical analysis, and assessments of production area performance to establish adherence to quality standards/scorecards; remains abreast of industry trends and technology changes; incorporates best practices in the development of quality standards, policies, programs, and system changes for the department; ensures that claims are processed according to appropriate risk selection principles • Coordinates and monitors training efforts to ensure that necessary education tools are provided to employees; identifies and communicates training needs and schedules with training department; projects staffing requirements for the business unit; guides supervisors in coaching and counseling employees; coordinates employee development and incentive initiatives • Identifies, analyzes, and monitors business technology requirements and enhancement possibilities; recommends viable technological solutions, modifications, and applications; prepares recommendations for implementation of initiatives; takes a leadership role in managing assigned initiatives; participates in and supports companywide initiatives through Quality Circles, Focus Groups, or other project initiatives • Monitors and controls operating expenses to ensure that corporate/divisional financial goals are met; provides input into the annual business unit budget; reviews legal files and coordinates with counsel to prepare for depositions and court hearings • Performs other related duties as required Total Rewards The salary range for this job is $80,000 to $110,000. This range is specific to the job and salary offers consider a wide range of factors that are considered in making compensation decisions, including, but not limited to: education, experience, licensure, certifications, geographic location, and peer compensation. The range has been created in good faith based on information known to Aflac at the time of the posting. At Aflac, it is not typical for an individual to be hired at or near the top of the range for the role to allow for future and continued salary growth, and compensation decisions are dependent on the circumstances of each case. This salary range does not include any potential incentive pay or benefits, however, such information will be provided separately when appropriate. In addition to the base salary, we offer an array of benefits to meet your needs including medical, dental, and vision coverage, prescription drug coverage, health care flexible spending, dependent care flexible spending, Aflac supplemental policies (Accident, Cancer, Critical Illness and Hospital Indemnity offered at no costs to employee), 401(k) plans, annual bonuses, and an opportunity to purchase company stock. On an annual basis, you’ll also be offered 11 paid holidays, up to 20 days PTO to be used for any reason, and, if eligible, state-mandated sick leave (Washington employees accrue 1-hour sick leave for every 40 hours worked) and other leaves of absence, if eligible, when needed to support your physical, financial, and emotional well-being. Aflac complies with all applicable leave laws, including, but not limited to, sick and safe leave, and adoption and parental leave, in all states and localities.