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.

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 Estimate Review Specialist Sr. (Repair Solutions) PRIMARY PURPOSE: To review all estimates and supporting documentation submitted by contractors/adjusters, using Xactimate, Symbility, and other estimating applications; to ensure estimates follow client and regulatory requirements and meet Sedgwick Repair Solutions’ guidelines while replacing a field adjuster if needed, and to serve as a subject matter expert on property restoration scope. ESSENTIAL RESPONSIBLITIES MAY INCLUDE - Apply your examiner 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. - Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. EDUCATION AND LICENSING Bachelor's degree in building construction from an accredited college or university preferred. Extensive water, mold, fire, smoke remediation and restoration experience preferred. IICRC Certification. TAKING CARE OF YOU BY - 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. - We offer a diverse and comprehensive benefits including medical, dental vision, 401K, PTO and more beginning your first day. NEXT STEPS If your application is selected to advance to the next round, a recruiter will be in touch. #claimsexaminer #claims As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $55,000-$57,000. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. Always accepting applications. 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.

About the role We are seeking a skilled BI-LIT Claims Examiner to manage litigated files and attend trials, conferences, mediations, and arbitrations. The successful candidate will: - Investigate and gather all necessary information and documentation related to claims - Evaluate liability and damages - Negotiate and settle claims - Manage litigation cases related to auto claims disputes The BI-LIT Claims Examiner will also be responsible for maintaining electronic files, analyzing defense counsel's performance, and regularly reporting to the Claims Manager. In addition, you will collaborate closely with our product and engineering teams to give feedback and identify technology and process improvements. Who you are - Highly motivated and growth-oriented. You're excited by the prospect of building a tech-driven claims org. - Passionate adjuster who cares about the customer and their experience. - Empathetic. You exercise empathy and patience towards everyone you interact with. - Sense of urgency - at all times. That does not mean working at all hours. - Creative. You can find the right exit ramp (pun intended) for the resolution of the claim that is in the insured’s best interest. - Conflict-enjoyer. Conflict does not have to be adversarial, but it HAS to be conversational. - Curious. You have to want to know the whole story so you can make the right decisions early and action them to a prompt resolution. - Anti-status quo. You don’t just wish things were done differently, you action on it. - Communicative. (we'd love to know what this means to you) - And did we mention, a sense of humor. Claims are hard enough as it is. What we need We need you to do all the things typical to the role: - Managing legal aspects of litigated cases, including evaluation of legal process and expenses - Analyzing and reviewing auto insurance claims to identify areas of dispute, investigating and gathering all necessary information and documentation related to the claim, evaluating liability and damages related to the claim, and negotiating and settling claims with opposing parties or their insurance providers - Managing litigation cases related to auto claims disputes, attending mediations, arbitrations, and court hearings as necessary, and communicating regularly with clients, claims adjusters, attorneys, and other stakeholders - Collaborating with defense counsel, claims counsel, and litigation claims management for strategic planning, including developing and maintaining positive working relationships with approved defense firms and other vendors in the industry - Reviewing legal documents and ensuring compliance with initial suit-handling plan of action - Serving as corporate representative for discovery review and depositions, and appearing as Corporate Representative at depositions and trials when needed - Analyzing policy language and reaching appropriate coverage decisions, drafting frequent and complex coverage correspondence, and proactively managing primarily litigated claim files from inception to closure - Directing and controlling the activities and costs of numerous outside vendors including defense counsel and coverage counsel, experts and independent adjusters - Maintaining adjuster licenses and continuing education requirements Requirements - Bachelor's degree (lack of one should not stop you from applying if you possess all the other qualifications) - 10+ years of claim handling experience, with 5+ of those years handling a pending of >60% in litigation - Transportation litigation (rideshare, auto, trucking, etc) is preferred but those with personal lines experience should still apply if they meet all other requirements. - You are not intimidated by an attorney, even if you are not one! You are the driver of the litigation strategy for any particular claim. You manage the discovery in the order and timing of events and hold attorney accountable - Understand transportation coverages. Understand contractual risk transfer and additional insured forms - You have strong medical knowledge - You have a sense of urgency and understanding of how to manage time-sensitive demands - Ability and willingness to communicate both on the phone and in written form in a prompt, courteous, and professional manner - Strong analytical and negotiation skills. You will conduct your own negotiations directly with opposing counsel - Knowledge of multiple state statutes, including good faith claim handling practices, regulations, and guidelines - Ability to professionally collaborate with all stakeholders in a claim - Have active adjuster license(s) and be willing to obtain all licenses within 45 days, including completing state required testing - Attention to detail, time management, and the ability to work independently in a fast-paced, remote environment - Curious and motivated by problem solving and questioning the status quo - Desire to engage in learning opportunities and continuous professional development - Willingness to travel for client and claims needs Benefits - Generous health-insurance package with nationwide coverage, vision, & dental - 401(k) retirement plan with employer matching - Competitive PTO policy – we want our employees fresh, healthy, happy, and energized! - Generous family leave policy after 8 months of continuous work - Work from anywhere to facilitate your work life balance - Apple laptop, large second monitor, and other quality-of-life equipment you may want. Technology is something that should make your life easier, not harder! Additionally, we will - Listen to your feedback to enhance and improve upon the long-standing challenges of an adjuster and the claims role - Work toward reducing and eliminating all the administrative work from an adjuster role - Foster a culture of empathy, transparency, and empowerment in a remote-first environment At Reserv, we value diversity in backgrounds, perspectives, and life experiences and believe that diversity in viewpoints and critical thinking drives innovation, first-principles thinking, and success. We welcome applicants from all backgrounds and encourage those from all walks of life to apply. If you believe you are a good fit for this role, we would love to hear from you!