Role Description The job profile for this position is Business Project Senior Advisor, which is a Band 4 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. Position Summary: Leads key components of large, high‑priority projects within PX&O Claim, with a primary focus on Proclaim Auto Adjudication, Claim Attachments, and automation initiatives. Serves as the business lead, partnering closely with technology teams to define scope, set priorities, manage risks, and deliver solutions on time. Uses Agile methods to drive enterprise initiatives, align stakeholders, and ensure the business is ready for successful implementation. Key Responsibilities - Identify and lead initiatives that improve efficiency, quality, and service across PX&O Claim operations. - Provide data, insights, and business context to support leadership decision‑making and prioritization. - Act as the Business Lead for Proclaim Auto Adjudication, partnering with business SMEs and Core Technology. - Lead technology consultants delivering robotic process automation for complex claim processes. - Apply Agile practices to define epics, features, and user stories; influence backlog priorities to meet business needs. - Approve solution designs and testing criteria; partner with operations and change management to ensure readiness. - Provide clear status updates, manage risks, and track outcomes to measure business impact. - Offer thought leadership in business project management and mentor less‑experienced analysts. Qualifications - High School Diploma or GED required. Bachelor’s degree preferred. - 10+ years Provider Claims operations experience, including Proclaim medical claim operations required. - 5+ years of experience in driving claim automation and process improvement initiatives highly preferred. - Deep knowledge of Provider Experience and Claim Operations; recognized as a subject‑matter expert. - Strong project management and organizational skills with the ability to manage multiple initiatives, often using Agile methodologies. - Proven ability to collaborate and influence in a matrixed environment. - Strategic thinker with strong problem‑solving skills. - Excellent written and verbal communication skills. - Ability to work independently in a fast‑paced, remote environment with a strong customer focus. Requirements - If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. Benefits - Comprehensive range of benefits focusing on supporting your whole health. - Health-related benefits including medical, vision, dental, and well-being and behavioral health programs starting on day one of your employment. - 401(k), company paid life insurance, tuition reimbursement. - A minimum of 18 days of paid time off per year and paid holidays. - This role is anticipated to be eligible to participate in an annual bonus plan. Company Description Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Role Description We’re looking for a Property, Auto, or General Liability (GL) Claims Team Lead to join ClaimSorted. This role is ideal for either: - an existing Claims Lead who wants to move faster, or - a strong Claims Handler who is ready to step up into leadership. We are not looking for tenure for the sake of it. We are looking for people with talent, ambition, work ethic, and the drive to build a real career. If you join us, we will give you the training and support to become the best Team Lead possible - from people management to performance management, data, quality, and capacity planning. Our goal is to help you become one of the best claims leaders of the future. Qualifications - Based in the United States with work authorization - 3+ years of claims experience in property, auto, or general liability (GL) - Strong organization and ability to prioritize independently - Comfortable using data to make decisions - Team-oriented, hardworking, and ambitious - Experience leading, mentoring, or coaching others is a plus - Startup or high-growth experience is a plus Requirements - Lead and line-manage a team of Claims Handlers - Drive performance across quality, productivity, and customer satisfaction - Manage workflow allocation and team capacity - Review claims quality and coach team members to improve - Maintain oversight of the claims portfolio and escalate risks early - Attend client meetings as a claims expert - Personally handle a small portfolio of claims to stay technically sharp Benefits - Competitive salary beyond the industry standard - Quarterly performance bonus: up to 15% of quarterly salary - Equity participation: stock options as an early-stage team member - Medical insurance - 401(k) with 5% company match - Paid time off - Accelerated promotion track in a high-growth environment

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 General Adjuster Northeast PRIMARY PURPOSE: To investigate claims against insurance or other companies for personal, casualty, or property loss or damages; attempts to effect out-of-court settlement with claimant. ESSENTIAL FUNCTIONS and RESPONSIBILITIES - Handles complex losses locally unassisted up to designated authority; assists on larger losses, including handling accounting-based losses (business interruption and stock) - Examines claim form and other records to determine insurance coverage. - Interviews, telephones, or corresponds with claimant and witnesses regarding claim. - Consults police and hospital records; and inspects property damage to determine extent of company's liability and varying methods of investigation according to type of insurance. - Estimates cost of repair, replacement, or compensation. - Prepares report of findings and negotiates settlement with claimant. - Recommends litigation by legal department when settlement cannot be negotiated. - Attends litigation hearings. - Revises case reserves in assigned claims files to cover probable costs. - Assists in preparing loss experience report to help determine profitability and calculates adequate future rates. ADDITIONAL FUNCTIONS and RESPONSIBILITIES - Performs other duties as assigned. - Supports the organization's quality program(s). - Travels as required. QUALIFICATIONS Education & Licensing Bachelor's degree from an accredited college or university preferred. Must have earned the IIA-AIC designation and be actively pursuing another professional insurance designation. Appropriate state adjuster license is required. Experience Five (5) years of related experience or equivalent combination of education and experience required. Skills & Knowledge - Strong oral and written communication, including presentation skills - PC literate, including Microsoft Office products - Demonstrated commitment to timely reporting - Strong customer service skills - Strong interpersonal skills - Attention to detail and accuracy - Good time management and organizational skills - Ability to work independently or 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 and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: - Must be able to stand and/or walk for long periods of time. - Must be able to kneel, squat or bend. - Must be able to work outdoors in hot and/or cold weather conditions. - Have the ability to climb, crawl, stoop, kneel, reaching/working overhead - Be able to lift/carry up to 50 pounds - Be able to push/pull up to 100 pounds - Be able to drive up to 4 hours per day. - Must have continual use of manual dexterity. 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. 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 $40k-$60k. 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. We are 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.

JOB SUMMARY The Patient Account Representative is responsible for working accounts to ensure they are resolved in a timely manner. This candidate should have a solid understanding of the Revenue Cycle as it relates to the entire life of a patient account from creation to payment. Representative will need to effectively follow-up on claim submission, remittance review for insurance collections, create and pursue disputed balances from both government and non-government entities. Basic knowledge of Commercial, Managed Care, Medicare and Medicaid insurance is preferable. An effective revenue cycle process is achieved with working as part of a dynamic team and the ability to adapt and grow in an environment where work assignments may change frequently while resolving accounts with minimal assistance. Representative must be able to work independently as well as work closely with management and team to take appropriate steps to resolve an account. Team member should possess the following: - Perform duties as assigned in a professional demeanor, which includes interacting with insurance plans, patients, physicians, attorneys and team members as needed. - Basic computer skills to navigate through the various system applications provided for additional resources in determining account actions - Access payer websites and discern pertinent data to resolve accounts - Utilize all available job aids provided for appropriateness in Patient Accounting processes - Document clear and concise notes in the patient accounting system regarding claim status and any actions taken on an account - Maintain department daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadership - Identify and communicate any issues including system access, payor behavior, account work-flow inconsistencies or any other insurance collection opportunities - Provide support for team members that may be absent or backlogged ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. - Researches each account using company patient accounting applications and internet resources that are made available. Conducts appropriate account activity on uncollected account balances with contacting third party payors and/or patients via phone, e-mail, or online. Problem solves issues and creates resolution that will bring in revenue eliminating re-work. Updates plan IDs, adjusts patient or payor demographic/insurance information, notates account in detail, identifies payor issues and trends and solves re-coup issues. Requests additional information from patients, medical records, and other needed documentation upon request from payors. Reviews contracts and identify billing or coding issues and request re-bills, secondary billing, or corrected bills as needed. Takes appropriate action to bring about account resolution timely or opens a dispute record to have the account further researched and substantiated for continued collection. Maintains desk inventory to remain current without backlog while achieving productivity and quality standards. - Perform special projects and other duties as needed. Assists with special projects as assigned, documents, findings, and communicates results. - Recognizes potential delays and trends with payors such as corrective actions and responds to avoid A/R aging. Escalates payment delays/ problem aged account timely to Supervisor. - Participate and attend meetings, training seminars and in-services to develop job knowledge. - Respond timely to emails and telephone messages as appropriate. - Ensures compliance with State and Federal Laws Regulations for Managed Care and other Third Party Payors. Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. - Thorough understanding of the revenue cycle process, from patient access (authorization, admissions) through Patient Financial Services (billing, insurance appeals, collections) procedures and policies - Intermediate skill in Microsoft Office (Word, Excel) - Ability to learn hospital systems – ACE, VI Web, IMaCS, OnDemand quickly and fluently - Ability to communicate in a clear and professional manner - Must have good oral and written skills - Strong interpersonal skills - Above average analytical and critical thinking skills - Ability to make sound decisions - Has a full understanding of the Commercial, Managed Care, Medicare and Medicaid collections, Intermediate knowledge of Managed Care contracts, Contract Language and Federal and State requirements for government payors - Familiar with terms such as HMO, PPO, IPA and Capitation and how these payors process claims. - Intermediate understanding of EOB. - Intermediate understanding of Hospital billing form requirements (UB04) and familiar with the HCFA 1500 forms. - Ability to problem solve, prioritize duties and follow-through completely with assigned tasks. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience preferred to perform the job. - High School diploma or equivalent. Some college coursework in business administration or accounting preferred - 1-4 years medical claims and/or hospital collections experience - Minimum typing requirement of 45 wpm PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. - Office/Team Work Environment - Ability to sit and work at a computer terminal for extended periods of time WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. - Call Center environment with multiple workstations in close proximity As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation and Benefit Information Compensation - Pay: $15.80 - $23.70 per hour. Compensation depends on location, qualifications, and experience. - Position may be eligible for a signing bonus for qualified new hires, subject to employment status. - Conifer observed holidays receive time and a half. Benefits Conifer offers the following benefits, subject to employment status: - Medical, dental, vision, disability, and life insurance - Paid time off (vacation & sick leave) – min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked. - 401k with up to 6% employer match - 10 paid holidays per year - Health savings accounts, healthcare & dependent flexible spending accounts - Employee Assistance program, Employee discount program - Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. - For Colorado employees, Conifer offers paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.