Claims Adjusters, Examiners, and Investigators

Description

The Program, Project, Product, and Vendor Management Team within Amazon’s Logistics Claims Management and Operations group is seeking a motivated and experienced Senior Risk Manager. The ideal candidate will be familiar with insurance and claims programs, and insurance policies, have a history of success in procurement, purchase order and budget management, process improvement, have vendor lifecycle management. They will support a growing and evolving insurance program, partnering with key stakeholders to identify business challenges and develop creative, often novel, solutions. They will use data and metrics to propose program enhancements and modify standards as needed to improve our ability to scale. They will be comfortable presenting issues and proposed solutions to all levels of leadership through superior written and verbal communication skills.

In this role, the Senior Risk Manager will use their expertise in procurement, account management, liability and insurance, analytical skills, and business acumen to deliver results. They will obsess over our customers (internal and external) and will work backward from the customer’s needs to create best-in-class processes. They are a trusted partner to our external partners and internal business operations and will leverage those trusting relationships to create excellent outcomes.

Key job responsibilities

• Manage all procurement activities, including setting budgets, forecasting costs, creating and paying purchaser orders, and proactively working to improve payment and reconciliation processes.

• Manage all aspects of vendor relationships, from process implementation to performance evaluation and improvement.

• Support document management and compliance.

• Clearly define and uphold performance standards based on organizational and team goals.

• Identify opportunities for improvements across the entire auto claims program and all lines of business.

• Effectively communicate recommended risk mitigation strategies and program/process improvements to cross-functional and internal leadership teams.

• Available for travel up to 25% of the time.

Basic Qualifications

- Bachelor's degree or equivalent

- 6+ years of compliance, audit or risk management experience

- Knowledge of Microsoft Office products and applications at an advanced level

Preferred Qualifications

- Project Management Professional (PMP) or equivalent certification

- Experience leveraging technology and implementing lean principles / Six Sigma methodologies to drive process improvements or equivalent

- Master's degree or equivalent

- Experience working in procurement systems, accounts payable systems, banking systems, or creating/managing cost forecasts.

Amazon is an equal opportunity employer and does not discriminate on the basis of protected veteran status, disability, or other legally protected status.

Our inclusive culture empowers Amazonians to deliver the best results for our customers. If you have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support for the interview or onboarding process, please visit https://amazon.jobs/content/en/how-we-hire/accommodations for more information. If the country/region you’re applying in isn’t listed, please contact your Recruiting Partner.

Our compensation reflects the cost of labor across several US geographic markets. The base pay for this position ranges from $109,000/year in our lowest geographic market up to $185,000/year in our highest geographic market. Pay is based on a number of factors including market location and may vary depending on job-related knowledge, skills, and experience. Amazon is a total compensation company. Dependent on the position offered, equity, sign-on payments, and other forms of compensation may be provided as part of a total compensation package, in addition to a full range of medical, financial, and/or other benefits. For more information, please visit https://www.aboutamazon.com/workplace/employee-benefits . This position will remain posted until filled. Applicants should apply via our internal or external career site.

Specialist Claims - CH07DESpecialist Claims CA - CH07DN

We’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and to help others accomplish theirs, too. Join our team as we help shape the future.

This is a visible and important role within our Complex Claims Unit (CCU) Hartford Global Specialty (HGS) Claims Division. As a Claims Specialist, you will be responsible for handling a caseload of higher complexity, higher exposure, construction defect claims from inception to final disposition. These claims will involve both primary and excess coverages and often involve complex fact patterns requiring analysis of contracts between parties to determine indemnity and contribution obligations and risk transfer opportunities. As these claims are often in litigation, experience handling litigated matters and managing defense counsel is required, as is prior experience handling construction defect and property damage claims. Excess claims handling experience is recommended but not required.

Responsibilities include, but are not limited, to:

+ Managing a caseload of litigated and non-litigated construction claims under commercial general liability policies.

+ Conducting investigations and analyzing and evaluating the information learned.

+ Making coverage determinations and communicating written position(s) to insureds and other required parties.

+ Within prescribed authority levels, setting appropriate expense and indemnity reserves and monitoring on a regular basis for any needed adjustment.

+ Presenting cases to management for expense or indemnity reserve authority above established authority levels.

+ Developing and implementing resolution strategies to achieve high quality outcomes.

+ Proactively managing litigation and counsel, inclusive of litigation planning and execution, budgeting, and bill review.

+ Attending trials and mediations, as necessary.

+ Contributing to broader claim and enterprise goals by participating in audits, projects, and product development initiatives.

+ Preparing comprehensive reports and delivering presentations to senior claim leadership on case developments, policy issues, industry trends, etc.

+ Working with business partners to evaluate and address claim trends and developments.

+ Addressing inquiries from agents and policyholders and providing superior customer service.

Position Requirements:

+ Bachelor’s degree preferred, law degree a plus or commensurate experience

+ Minimum of 7 seven years handling complex litigated construction defect and bodily injury matters

+ Familiarity with owner and contractor-controlled insurance policies and programs as well as wrap policies, is a plus

+ High level of discipline, results-oriented and able to focus on bottom line results

+ Superior analytical ability and organizational skills

+ Excellent oral and written communication skills

+ Excellent strategic thinking ability and execution skills

+ Excellent negotiation and advanced technical claim handling skills, including knowledge of coverage and tort laws

+ Full command of damages issues relative to high value construction defect and property damage claims

+ Strong ability to analyze coverage and liability issues, manage time limit demands and assess extra contractual exposures and other issues of complexity

+ Ability to communicate thoughts clearly and concisely, and to influence and persuade others

+ Superior interpersonal skills

+ Ability to exceed expectations and influence others to do the same

This role can have a Hybrid or Remote work arrangement. Candidates who live near one of our office locations (Hartford, CT, San Antonio, TX, Lake Mary, FL, Phoenix, AZ, Naperville, IL) will have the expectation of working in an office 3 days a week (Tuesday through Thursday). Candidates who do not live near an office will have a remote work arrangement, with the expectation of coming into an office as business needs arise.

Compensation

The listed annualized base pay range is primarily based on analysis of similar positions in the external market. Actual base pay could vary and may be above or below the listed range based on factors including but not limited to performance, proficiency and demonstration of competencies required for the role. The base pay is just one component of The Hartford’s total compensation package for employees. Other rewards may include short-term or annual bonuses, long-term incentives, and on-the-spot recognition. The annualized base pay range for this role is:

$106,400 - $159,600

The posted salary range reflects our ability to hire at different position titles and levels depending on background and experience.

Equal Opportunity Employer/Sex/Race/Color/Veterans/Disability/Sexual Orientation/Gender Identity or Expression/Religion/Age

About Us (https://www.thehartford.com/about-us) | Our Culture (https://www.thehartford.com/about-us/corporate-culture) | What It’s Like to Work Here (https://www.thehartford.com/careers/our-employees) | Perks & Benefits (https://www.thehartford.com/careers/benefits)

Every day, a day to do right.

Showing up for people isn’t just what we do. It’s who we are – and have been for more than 200 years. We’re devoted to finding innovative ways to serve our customers, communities and employees—continually asking ourselves what more we can do.

Is our policy language as simple and inclusive as it can be? Can we better help businesses navigate our ever-changing world? What else can we do to destigmatize mental health in the workplace? Can we make our communities more equitable?

That we can rise to the challenge of these questions is due in no small part to our company values that our employees have shaped and defined.

And while how we contribute looks different for each of us, it’s these values that drive all of us to do more and to do better every day.

About Us (https://www.thehartford.com/about-us)

Our Culture

What It’s Like to Work Here (https://www.thehartford.com/careers/our-employees)

Perks & Benefits (https://www.thehartford.com/careers/benefits)

Legal Notice (https://www.thehartford.com/legal-notice)

Accessibility StatementProducer Compensation (https://www.thehartford.com/producer-compensation)

EEO

Privacy Policy (https://www.thehartford.com/online-privacy-policy)

California Privacy Policy

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International Privacy Policy

Canadian Privacy Policy (https://www.thehartford.com/canadian-privacy-policy)

Unincorporated Areas of LA County, CA (Applicant Information)

MA Applicant Notice (https://www.thehartford.com/ma-lie-detector)

Claims Representative - CH09CNAssociate Claim Representative - CH10DN

We’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and to help others accomplish theirs, too. Join our team as we help shape the future.

As a General Liability Associate Claims Representative for all business lines, you’re at the front lines for our customer. Your primary role is to investigate and manage claim files to help individuals and businesses prevail after a claim. The Hartford will provide you with a robust training and onboarding program, as well as ongoing coaching and development to ensure your success.

Start Date: October 6, 2025

Hours: 8am-5pm, Core Business hours to support either our Eastern or Western region, limited flexibility.

Virtual Training: 6 weeks, core business hours, your local time

This role will have a Hybrid work arrangement, with the expectation of working in an office location : (Hartford, CT / San Antonio, TX / Aurora (Naperville) IL/ Lake Mary, FL/ Scottsdale, AZ ) 3 days a week (Tuesday through Thursday).

Responsibilities:

+ Utilize active listening and critical thinking skills to quickly analyze customer needs

+ Leverage knowledge and resources to provide the appropriate solutions to requests

+ Take ownership to ensure that we go above and beyond in providing customer service

+ Utilize every touch point as an opportunity to build value and The Hartford brand

+ Commit to learning and developing

+ Develop an in depth understanding of Hartford products and business lines

+ Act as a liaison with other departments to resolve problems

+ Secure essential facts about losses

+ Negotiate settlements

+ Interpret, understand and explain coverage to policyholders

+ Efficiently update and move files to closure

+ Manage pending claims to meet company quality criteria

+ Ensure payments are processed timely as needed or input payments within authority

+ Special assignments or projects as assigned

+ May be required to assist in catastrophe situations

+ Develop proficiency and capabilities expected during new hire ramp-up period

+ Must demonstrate strong customer service focus

+ Ability to operate, lead and coach within The Hartford Way management system

Qualifications:

+ High School Diploma required; college degree preferred

+ Minimum of 1 year of related customer service experience or applicable insurance experience

+ Excellent oral, written and interpersonal communication

+ Demonstrated capacity to multi-task in a structured work environment

+ Ability to utilize multiple systems to handle/process claims

+ Problem solving and critical thinking skills are a must

+ Strong attention to detail

Additional Information:

+ As a condition of your employment, you must obtain and maintain a State Adjuster's License to process Property & Casualty Insurance Claims in the states supported by your office. Continued employment with The Hartford is contingent upon the successful passage of the Licensing exam(s) within 30 business days from the completion of the licensing training.

Compensation

The listed annualized base pay range is primarily based on analysis of similar positions in the external market. Actual base pay could vary and may be above or below the listed range based on factors including but not limited to performance, proficiency and demonstration of competencies required for the role. The base pay is just one component of The Hartford’s total compensation package for employees. Other rewards may include short-term or annual bonuses, long-term incentives, and on-the-spot recognition. The annualized base pay range for this role is:

$45,280 - $79,320

The posted salary range reflects our ability to hire at different position titles and levels depending on background and experience.

Equal Opportunity Employer/Sex/Race/Color/Veterans/Disability/Sexual Orientation/Gender Identity or Expression/Religion/Age

About Us (https://www.thehartford.com/about-us) | Our Culture (https://www.thehartford.com/about-us/corporate-culture) | What It’s Like to Work Here (https://www.thehartford.com/careers/our-employees) | Perks & Benefits (https://www.thehartford.com/careers/benefits)

Every day, a day to do right.

Showing up for people isn’t just what we do. It’s who we are – and have been for more than 200 years. We’re devoted to finding innovative ways to serve our customers, communities and employees—continually asking ourselves what more we can do.

Is our policy language as simple and inclusive as it can be? Can we better help businesses navigate our ever-changing world? What else can we do to destigmatize mental health in the workplace? Can we make our communities more equitable?

That we can rise to the challenge of these questions is due in no small part to our company values that our employees have shaped and defined.

And while how we contribute looks different for each of us, it’s these values that drive all of us to do more and to do better every day.

About Us (https://www.thehartford.com/about-us)

Our Culture

What It’s Like to Work Here (https://www.thehartford.com/careers/our-employees)

Perks & Benefits (https://www.thehartford.com/careers/benefits)

Legal Notice (https://www.thehartford.com/legal-notice)

Accessibility StatementProducer Compensation (https://www.thehartford.com/producer-compensation)

EEO

Privacy Policy (https://www.thehartford.com/online-privacy-policy)

California Privacy Policy

Your California Privacy Choices (https://www.thehartford.com/data-privacy-opt-out-form)

International Privacy Policy

Canadian Privacy Policy (https://www.thehartford.com/canadian-privacy-policy)

Unincorporated Areas of LA County, CA (Applicant Information)

MA Applicant Notice (https://www.thehartford.com/ma-lie-detector)

Specialist Claims - CH07DE

We’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and to help others accomplish theirs, too. Join our team as we help shape the future.

As a Claim Specialist for Primary and Excess Liability Claims in the Hartford Global Specialty (HGS) Liability Major Case Unit, you will be responsible for handling a caseload of bodily injury and non-bodily injury claims. The claims often involve complex fact patterns requiring analysis of contracts between parties to determine indemnity and contribution obligations and risk transfer opportunities. As these claims are often in litigation, experience handling litigated matters and managing defense counsel is required, as is prior experience handling primary and excess policy coverages and claims.

Qualifications:

+ Conducting investigations and analyzing and evaluating the information learned;

+ Making coverage determinations and communicating written position(s) to insureds and other required parties;

+ Within prescribed authority levels, setting appropriate expense and indemnity reserves and monitoring on a regular basis for any needed adjustment;

+ Presenting cases to management for expense or indemnity reserve authority above established authority levels;

+ Developing and implementing resolution strategies to achieve high quality outcomes;

+ Proactively managing litigation and counsel, inclusive of litigation planning and execution, budgeting and bill review;

+ Attending trials and mediations as necessary;

+ Contributing to broader claim and enterprise goals by participating in audits, projects and product development initiatives;

+ Preparing comprehensive reports and delivering presentations to senior claim leadership on case developments, policy issues, industry trends, etc.;

+ Providing support to field offices to assist field personnel with coverage and liability analysis, time limit demands, extra contractual exposure evaluations and other issues of complexity;

+ Work with business partners to evaluate and address claim trends and developments; and

+ Address inquiries from agents and policyholders, providing superior customer service.

Qualifications:

+ Bachelor’s degree strongly preferred; law degree a plus.

+ Minimum of five plus years handling complex litigated coverage and commercial general liability matters.

+ Candidate should be disciplined, results-oriented and able to focus on bottom line results.

+ Superior analytical ability and organizational skills.

+ Excellent oral and written communication skills.

+ Excellent strategic thinking ability and execution skills.

+ Excellent negotiation and advanced technical claim handling skills, including knowledge of coverage and tort laws.

+ An ability to communicate thoughts clearly and concisely, and to influence and persuade others.

+ Superior interpersonal skills.

+ An ability to exceed expectations and influence others

This role can have a Hybrid or Remote work arrangement. Candidates who live near one of our office locations (Hartford, CT, San Antonio, TX, Lake Mary, FL, Scottsdale, AZ, Naperville, IL,) will have the expectation of working in an office 3 days a week (Tuesday through Thursday). Candidates who do not live near an office will have a remote work arrangement, with the expectation of coming into an office as business needs arise. Travel required up to 10%.

Compensation

The listed annualized base pay range is primarily based on analysis of similar positions in the external market. Actual base pay could vary and may be above or below the listed range based on factors including but not limited to performance, proficiency and demonstration of competencies required for the role. The base pay is just one component of The Hartford’s total compensation package for employees. Other rewards may include short-term or annual bonuses, long-term incentives, and on-the-spot recognition. The annualized base pay range for this role is:

$106,400 - $159,600

Equal Opportunity Employer/Sex/Race/Color/Veterans/Disability/Sexual Orientation/Gender Identity or Expression/Religion/Age

About Us (https://www.thehartford.com/about-us) | Our Culture (https://www.thehartford.com/about-us/corporate-culture) | What It’s Like to Work Here (https://www.thehartford.com/careers/our-employees) | Perks & Benefits (https://www.thehartford.com/careers/benefits)

Every day, a day to do right.

Showing up for people isn’t just what we do. It’s who we are – and have been for more than 200 years. We’re devoted to finding innovative ways to serve our customers, communities and employees—continually asking ourselves what more we can do.

Is our policy language as simple and inclusive as it can be? Can we better help businesses navigate our ever-changing world? What else can we do to destigmatize mental health in the workplace? Can we make our communities more equitable?

That we can rise to the challenge of these questions is due in no small part to our company values that our employees have shaped and defined.

And while how we contribute looks different for each of us, it’s these values that drive all of us to do more and to do better every day.

About Us (https://www.thehartford.com/about-us)

Our Culture

What It’s Like to Work Here (https://www.thehartford.com/careers/our-employees)

Perks & Benefits (https://www.thehartford.com/careers/benefits)

Legal Notice (https://www.thehartford.com/legal-notice)

Accessibility StatementProducer Compensation (https://www.thehartford.com/producer-compensation)

EEO

Privacy Policy (https://www.thehartford.com/online-privacy-policy)

California Privacy Policy

Your California Privacy Choices (https://www.thehartford.com/data-privacy-opt-out-form)

International Privacy Policy

Canadian Privacy Policy (https://www.thehartford.com/canadian-privacy-policy)

Unincorporated Areas of LA County, CA (Applicant Information)

MA Applicant Notice (https://www.thehartford.com/ma-lie-detector)

**What’s Under the Hood**

DriveTime Family of Brands includes SilverRock, which provides quality warranty and ancillary products, and a customer-friendly claims process. SilverRock offers a variety of ancillary products and administrative services encompassing everything from GAP coverage to vehicle theft and GPS tracking to dealership fleet management. Our ancillary product expertise is proven with over 1 million service contracts, products, and warranties, and over $300 million in claims.

**That’s Nice, But What’s the Job?**

In short, as a Claims Adjuster, you will use your knowledge of vehicle systems and repairs to validate, approve, and authorize payment for repair recommendations on warranty claims. You’ll work over the phone with service advisers and technicians to ensure correct repairs are performed to help get our customers back on the road, so automotive experience is a must!

**So What Kind of Folks Are We Looking for?**

+ **Passionate and goal-oriented.** We are looking for someone that is enthusiastic about their career and is passionate about meeting and exceeding their goals.

+ **Excellent verbal and written communication skills.** The ability to talk and write with confidence, charisma, and competence to a wide variety of audiences.

+ **Agile in a fast-paced environment** . We move, and we move quickly. Thriving in and contributing to an environment that never stops is a must.

+ **Plays well with others.** You will be working in a high-functioning team environment. We work together and we win together.

+ **Works well in a time crunch.** There will be multiple time-sensitive requirements and you will need the ability to meet deliverable due dates.

+ **Fantastic problem solver!** Some calls will be challenging. Your goal is not only to find the problem but more importantly, find the solution.

+ **Positive emotional resilience.** This is an environment where you will be faced with challenging calls on a daily basis. We want to make sure you have the ability to rise past them while maintaining an optimistic attitude.

**The Specifics.**

+ High School diploma required; Associate or Bachelor’s deree is preferred

+ 3 + years of experience with current automotive mechanical and diagnostics

+ **_Must be located in AZ, FL, GA, NC, TN, TX, UT or NV._**

**So What About the Perks? Perks matter**

+ **Work From Home.** Feel free to rock the casual wear while still being camera ready. You will be working from your home office (in an approved city & state) and make sure you have a conducive and quiet workspace with no distractions and reliable and secure internet.

+ **Medical, dental, and vision, oh my!** DriveTime Family of Brands covers a sizable amount of insurance premiums to ensure our employees receive top-tier healthcare coverage.

+ **But Wait, There’s More.** 401(K), Company paid life insurance policy, short and long-term disability coverage to name a few.

+ **Growth Opportunities.** You grow, I grow, we all grow! But seriously, DriveTime Family of Brands is committed to providing its employees with every opportunity to grow professionally with roughly over 1,000 employees promoted year over year.

+ **Tuition Reimbursement.** We’re as passionate about your professional development as you are. With that, we’ll put our money where our mouth is.

+ **Wellness Program.** Health is wealth! This program includes self-guided coaching and journeys, cash incentives and discounts on your medical premiums through engaging in fun activities!

+ **Gratitude is Green.** We offer competitive pay across the organization, because, well… money matters!

+ **Consistent Work Schedule.** You’ll get a set schedule Monday through Friday, with rotating Saturdays! With that, we do ask for some flexibility and overtime as needed.

+ **Game Room.** Gimme a break – no, not a Kit Kat ad but we do have a ping-pong table, a pool table and other games if you ever need a break in your day.

+ **In-House Gym.** We want our employees to be the best versions of themselves. So come early, take a break in your day, or finish strong with a workout!

+ **Enjoy Social Events?** Bring it on. Rally with your team for festive gatherings, team competitions or just to hang out!

+ **We Care and Value YOU!** Feel the love and let us treat you to company outings, personal rewards, amazing prizes & much more!

+ **Paid Time Off.** Not just lip service: we work hard, to play hard! Paid time off includes (for all full-time roles) wellness days, holidays, and good ole' fashioned YOU time! For our Part-timers, don't fear you get some time too...vacation time is available - the more you work, the more you earn!

**Anything Else? Absolutely.**

DriveTime Family of Brands is Great Place to Work Certified! And get this: 90% of our rockstar employees say they feel right at home here. We could spend a lot of time having you read about ALL our awards, but we’ll save time (and practice some humility) just naming a few others; Comparably Awards: Best Company for Diversity, Best Company Culture and Best Company Leadership, oh and don’t forget Phoenix Business Journal Healthiest Employers (okay, we’ll stop there)!

Hiring is contingent upon successful completion of our background and drug screening process. DriveTime is a drug-free, tobacco-free workplace and an Equal Opportunity Employer.

And when it comes to hiring, we don't just look for the right person for the job, we seek out the right person for DriveTime. Buckle up for plenty of opportunities to grow in a professional, fun, and high-energy environment!

Cognizant is one of the world’s leading professional services companies, we help our clients modernize technology, reinvent processes, and transform experiences, so they can stay ahead in our constantly evolving world. We are looking to expand our team. Do you thrive in a busy environment and able to multi-task successfully? If so, please apply today!

The Claims Processor, you will ensure accurate and timely adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support to claims and client issues related to claims adjudication and adjustments. Service Now and Inquiry resolution, and any basic questions regarding health coverage as stated in the employer’s plan document. You will be valued member of the Cognizant team and collaborate with stakeholders and other teams.

**Primary Responsibilities** :

+ Review claim system data and verify against UB or HCFA paper or EDI information.

+ Evaluate medical records to determine if the service rendered was medically appropriate and criteria compliance.

+ Analyze claim and line-item edits, including warning messages, to determine payment eligibility.

+ Manage all tasks within designated timeline to meet internal and external SLAs.

+ Other duties as assigned by management.

**Qualifications:**

+ A minimum of 1 year’s claims processing experience is required.

+ Knowledge of physician practice and hospital coding, billing and medical terminology, CPT, HCPCA, ICD-9

+ Experience with UB/institutional (CMS-1450) and/or professional (CMS 1500) claims.

+ Knowledge of Medicare billing & payment and coverage guidelines and regulations.

+ Must be able to work with minimal supervision.

+ Excellent problem-solving skill in healthcare claims adjudication.

+ Ability to work at a computer for extended periods.

+ High School degree or GED or equivalent experience.

Cognizant will only consider applicants for this position who are legally authorized to work in the United States without requiring company sponsorship now or at any time in the future.

**Salary and Other Compensation:**

Applications will be accepted until August 8, 2025

The hourly rate for this position is between $15.25 - $17.75 an hour, depending on experience and other qualifications of the successful candidate. This position is also eligible for Cognizant’s discretionary annual incentive program, based on performance and subject to the terms of Cognizant's applicable plans.

**Benefits** : Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:

+ Medical/Dental/Vision/Life Insurance

+ Paid holidays plus Paid Time Off

+ 401(k) plan and contributions

+ Long-term/Short-term Disability

+ Paid Parental Leave

+ Employee Stock Purchase Plan

**Disclaimer:** The hourly rate, other compensation, and benefits information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.

Cognizant is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.

We strive to provide flexibility wherever possible. Based on this role’s business requirements, this is a remote position open to qualified applicants in the United States. Regardless of your working arrangement, we are here to support a healthy work-life balance though our various wellbeing programs.

**Location:** Remote (Work-from-Home)

**Schedule:** Monday to Friday 8am - 4:30pm ET

**Experience:** A minimum of 1 years claims processing is required.

**Travel:** None required

**About the role:**

As Claims Processor, you will be responsible for timely and accurate adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support to claims and client for issues related to claims adjudication and adjustments, Service Now and Inquiry resolution, and any basic questions regarding health coverage as stated in the employer's Plan Document. You will be a valued member of the Cognizant team and work collaboratively with stakeholders and other teams.

**In this role, you will:**

• Be Responsible for reviewing the data in the claim processing system and comparing with corresponding UB or HCFA paper or EDI information.

• Responsible for reviewing medical records when necessary to determine if service rendered was medically appropriate and criteria have been met.

• Responsible for reviewing claim and line-item edits and warning messages for determination of whether to pay claim/line item(s).

• Ensuring all designated tasks are handled within the appropriate timeframe in order to meet internal and external SLAs.

• Assigning special projects or other duties as determined by management.

**What you need to have to be considered:**

• A minimum of 1 year claims processing is required.

• Knowledge of physician practice and hospital coding, billing and medical terminology, CPT, HCPCS, ICD-9

• Experience with UB/institutional (CMS-1450) and/or professional (CMS 1500) claims

• Knowledge of Medicare billing & payment and coverage guidelines and regulations.

• Experience in the analysis and processing of claims, utilization review/quality assurance procedures.

• Must be able to work with minimal supervision.

• Creative thinker with good skills a problem resolution specifically related to healthcare claim adjudication.

• Possess ability to work at a computer for extended periods.

• Can work closely with other departments

**Required Education and Experience**

· High School degree or GED or equivalent experience.

The working arrangements for this role are accurate as of the date of posting. This may change based on the project you’re engaged in, as well as business and client requirements. Rest assured; we will always be clear about role expectations.

**Salary and Other Compensation:**

**Applications will be accepted until August 8th, 2025.**

The hourly rate for this position is between $15.25 - $17.75 per hour depending on experience and other qualifications of the successful candidate.

**Benefits:** Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:

· Medical/Dental/Vision/Life Insurance

· Paid holidays plus Paid Time Off

· 401(k) plan and contributions

· Long-term/Short-term Disability

· Paid Parental Leave

· Employee Stock Purchase Plan

Disclaimer: The hourly rate, other compensation, and benefits information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.

Cognizant will only consider applicants for this position who are legally authorized to work in the United States without requiring company sponsorship now or at any time in the future.

Cognizant is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.

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

Claims Examiner, Auto (Commercial Trucking Bodily Injury)

**PRIMARY PURPOSE** : To analyze and process **complex auto and commercial trucking transportation claims** by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.

**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**

+ Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly.

+ Responsible for litigation process on litigated claims.

+ Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims.

+ Reports large claims to excess carrier(s).

+ Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.

+ Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage.

+ Communicates claim action/processing with insured, client, and agent or broker when appropriate.

**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. Professional certification as applicable to line of business preferred. Secure and maintain the State adjusting licenses as required for the position.

**Experience**

Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage’s, principles, and laws.

**Skills & Knowledge**

+ In-depth knowledge of personal and commercial line auto policies, coverage’s, principles, and laws

+ Knowledge of medical terminology for claim evaluation and Medicare compliance

+ Knowledge of appropriate application for deductibles, sub-limits, SIR’s, carrier and large deductible programs.

+ Strong oral and written communication, including presentation skills

+ PC literate, including Microsoft Office products

+ Strong organizational skills

+ Strong interpersonal skills

+ Good negotiation skills

+ Ability to work in a team environment

+ Ability to meet or exceed Service Expectations

**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

_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_ **_$80,000- $85,000._** _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.**

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.

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.**

**Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

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

Claims Representative, Auto (Commercial Trucking)

**PRIMARY PURPOSE** : To analyze and process low to mid-level auto and transportation claims.

**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**

+ Processes auto property damage and lower level injury claims; assesses damage, makes payments, and ensures claim files are properly documented and correctly coded based on the policy.

+ Develops and maintains action plans to ensure state required contract deadlines are met and to move the file towards prompt and appropriate resolution.

+ Identifies and pursues subrogation opportunities; secures and disposes of salvage.

+ Communicates claim action/processing with insured, client, and agent or broker when appropriate.

+ Maintains professional client relations.

+ Performs coverage, liability, and damage analysis on all claims assignments.

**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. Secure and maintain the State adjusting licenses as required for the position.

**Experience**

Three (3) years of commercial line property claims management experience or equivalent combination of education and experience required to include knowledge of construction basics.

**Skills & Knowledge**

+ Familiarity with personal and commercial lines policies and endorsements

+ Ability to review and assess Property Damage estimates, total loss evaluations, and related expenses to effectively negotiate first and third party claims.

+ Knowledge of total loss processing, State salvage forms and title requirements.

+ Excellent oral and written communication, including presentation skills

+ PC literate, including Microsoft Office products

+ Analytical and interpretive skills

+ Strong organizational skills

+ Good interpersonal skills

+ Ability to work in a team environment

+ Ability to meet or exceed Service Expectations

**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

**NOTE** : Credit security clearance, confirmed via a background credit check, is required for this position.

_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- $60,000_ _. 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._

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.

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.**

**Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

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

Auto Claims Adjuster

**PRIMARY PURPOSE** **:** To analyze mid- and higher-level general auto claims to determine scope of damages; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.

**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**

+ Manages mid-level and higher-level auto commercial and personal lines claims by gathering information to determine exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.

+ Assesses liability and resolves claims within evaluation.

+ Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.

+ Manages subrogation of claims and negotiates settlements.

+ Communicates claim action with claimant and client.

+ Ensures claim files are properly documented and claims coding is correct.

+ Maintains professional client relationships.

**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**

+ Performs other duties as assigned.

+ Travels as required.

**QUALIFICATIONS**

**Education & Licensing**

Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Secure and maintain the State adjusting licenses as required for the position.

**Experience**

Four (4) years of claims management experience or equivalent combination of education and experience required.

**Skills & Knowledge**

+ Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles as applicable to line-of-business.

+ Excellent oral and written communication skills, including presentation skills

+ PC literate, including Microsoft Office products

+ Analytical and interpretive skills

+ Strong organizational skills

+ Excellent interpersonal skills

+ Excellent 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

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 $25.00 to $35.00 USD/HR . This role is eligible for 401k.

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.

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.**

**Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**