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.

Role Description In this role you will have oversight over the Absence Paid Family & Medical Leave claims team. Your day will involve: - Overseeing your team’s daily operations - Monitoring performance metrics - Ensuring timely, accurate processing of claims - Collaborating with other business areas as PFML state laws are updated or change - Resolving complex issues with other departments - Driving continuous process improvements - Keeping the team aligned with evolving compliance standards Qualifications - 5+ years of disability or absence claims leadership experience - Strong leadership and communication skills - Ability to thrive in a fast-paced, ever-changing environment - Demonstrated ability to use independent judgment and think creatively - Ability to travel: 25% - Promote a culture of diversity and inclusion - Able to work remotely with access to a high-speed internet connection Requirements - Lead and manage the Absence Claims department - Develop, implement, and monitor quality assurance processes - Collaborate with HR, legal, and other departments - Stay current on federal and state legislation affecting claims processing - Drive continuous process improvement - Represent the Claims department as a subject matter expert - Partner with Learning and Development to establish effective training programs Benefits - Estimated Salary: $80,000 - $95,000 plus annual bonus opportunity - 401(k) plan with a 2% company contribution and 6% company match - Work-life balance with vacation, personal time, and paid holidays

Overview Position Title: CA Work Comp Adjuster - Spanish Bilingual Preferred Location: Concord, CA (Reporting Remotely)Schedule: 8am - 4:30pm Salary Range: $75,000 - $95,000 (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 seeking a driven and compassionate Workers’ Compensation Claim Specialist to join our team and make a meaningful impact in the lives of injured workers. In this role, you will take ownership of a dedicated portfolio of claims—leading investigations, determining compensability, and guiding each case toward a fair and timely resolution. This position offers the opportunity to grow your technical expertise and can serve as an advanced development path for future supervisory or management roles. As a Claim Specialist, you play a vital role in delivering the high‑quality service our clients count on and upholding CCMSI’s commitment to excellence. Responsibilities When we hire Workers’ Compensation Adjusters at CCMSI, we look for detail‑driven problem‑solvers who balance empathy with sound judgment, navigate complex regulations with confidence, and deliver fair, timely outcomes that support injured workers and strengthen client trust. - Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws. - Establish reserves and/or provide reserve recommendations within established reserve authority levels. - Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims. Negotiate any disputed bills or invoices for resolution. - Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority. - Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate. - Assist in the selection, referral and supervision of designated claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.) - Review and maintain personal diary on claim system. - Assess and monitor subrogation claims for resolution. - Compute disability rates in accordance with state laws. - Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process. - Provide notices of qualifying claims to excess/reinsurance carriers. - Compliance with Corporate Claim Handling Standards and special client handling instructions as established. Qualifications Required: - 5+ years of Workers’ Compensation claims handling experience, including full claim investigation, evaluation, and resolution. - Responsiveness to internal and external client needs. - Strong analytical and negotiation abilities. - Knowledge of all lower‑level claim position responsibilities. - Adjuster’s license may be required based on jurisdiction. Nice to Have: - Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required. - Bachelor's degree is preferred but not required - Professional designations such as AIC, ARM, or CPCU are preferred but not required Why You’ll Love Working Here - 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 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 How We Measure Success At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by: - Quality claim handling – thorough investigations, strong documentation, well-supported decisions - Compliance & audit performance – adherence to jurisdictional and client standards - Timeliness & accuracy – purposeful file movement and dependable execution - Client partnership – proactive communication and strong follow-through - Professional judgment – owning outcomes and solving problems with integrity - Cultural alignment – believing every claim represents a real person and acting accordingly This is where we shine, and we hire adjusters who want to shine with us. 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. This role may also qualify for bonuses or additional forms of pay. CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents. 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. Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws. 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 #ReadyToWork #ESOP #IND123 #LI-Remote