Claims representative jobs in San Juan, PR

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 (IAP) - Workers Compensation Training Program Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career? + A stable and consistent work environment in an office setting. + A training program to learn how to help employees and customers from some of the world's most reputable brands. + An assigned mentor and manager who will guide you on your career journey. + Career development and promotional growth opportunities through increasing responsibilities. + A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs. **PRIMARY PURPOSE OF THE ROLE:** To be oriented and trained as new industry professional with the ability to analyze workers compensation claims and determine benefits due. **ARE YOU AN IDEAL CANDIDATE?** We are seeking enthusiastic individuals for an entry-level trainee position. This role begins with a comprehensive 6-week classroom-based professional training program designed to equip you with the foundational skills needed for a successful career in claims adjusting. Over the course of a few years, you'll have the opportunity to grow and advance within the field. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Attendance and completion of designated classroom claims professional training program. + Performs on-the-job training activities including: + Adjusting lost-time workers compensation claims under close supervision. May be assigned medical only claims. + Adjusting low and mid-level liability and/or physical damage claims under close supervision. + Processing disability claims of minimal disability duration under close supervision. + Documenting claims files and properly coding claim activity. + Communicating claim action/processing with claimant and client. + Supporting other claims examiners and claims supervisors with larger or more complex claims as assigned. + Participates in rotational assignments to provide temporary support for office needs. **QUALIFICATIONS** Bachelor's or Associate's degree from an accredited college or university preferred. **EXPERIENCE** Prior education, experience, or knowledge of: - Customer Service - Data Entry - Medical Terminology (preferred) - Computer Recordkeeping programs (preferred) - Prior claims experience (preferred) Additional helpful experience: - State license if required (SIP, Property and Liability, Disability, etc.) - WCCA/WCCP or similar designations - For internal colleagues, completion of the Sedgwick Claims Progression Program **TAKING CARE OF YOU** + Entry-level colleagues are offered a world class training program with a comprehensive curriculum + An assigned mentor and manager that will support and guide you on your career journey + Career development and promotional growth opportunities + A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more _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 25.65/hr. 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. #claims #claimsexaminer #entrylevel #remote #LI-Remote_ 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**

Claims Representative I Location Hybrid 1: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Office Location: 654 Avenue Luis Munoz Rivera, San Juan, 00918 The Claims Representative I responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery. How you will make an impact: Learning the activities/tasks associated with his/her role. Works under direct supervision. Relies on others for instruction, guidance, and direction. Work is reviewed for technical accuracy and soundness. Codes and processes claims forms for payment ensuring all information is supplied before eligible payments are made. Researches and analyzes claims issues. Minimum Requirements HS diploma or equivalent and related experience; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities and Experiences Good oral and written communication skills, previous experience using PC, database system, and related software (word processing, spreadsheets, etc.) strongly preferred. Familiarity with Medicare/Medicaid and claims. Medical background (e.g., hospital or dental office experience). Data entry experience. Experience working with production goals. Call center experience. Job Level: Non-Management Non-Exempt Workshift: Job Family: CLM > Claims Reps Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Role Purpose The Accident and Health Claims Adjuster is responsible to handle, investigate, analyze, calculate and approve insurance claims filed by policyholders and determine the extent of insurance company's liability concerning Accident and Health claims. Key Responsabilities Manage, evaluate and adjust Accident & Health claims as per the policy terms and conditions including application of exclusions if applicable. Work and manage as many fast track claims as possible (Medical Expenses) and analyze medical records. Assist in resolving complaints from policyholders relative to claims. Comply with OCS, PMP objectives, Claims Best Practices guidelines & standards of services as required. Do coverage determination position letters to policyholders. Perform specials projects and other related duties as assigned. Make timely decisions on claim approval, partial payment, or denial with clear justifications. Identify potential fraudulent claims and refer cases as necessary for investigation. Bachelor's Degree in Business Administration. Adjusters License from the Office of the Commissioner of Insurance of Puerto Rico (OCS). Demonstrated experience and/or knowledge in claims related to the following coverage's: Accident, Medical Expenses, Cancer, Critical Illnesses, Disability, Hospitalization, and SINOT, among others including policy interpretation. Strong ability to perform mathematical calculations. Demonstrate flexibility and adaptability to work in a fast moving and challenging environment. Proficient in MS Applications (Word, Excel and Power Point). Intermediate knowledge of the structure and content of the English and Spanish Language.

* College degree or an equivalent combination of education and experience. * Minimum 2 years insurance adjusting experience with experience in each of at least two lines of business (casualty, property, or marine). * Personal computer, typing and keyboarding skills * In-depth knowledge of insurance coverage, practices and negotiating skills in multiple lines of business. * Familiarity with legal, medical and technical disciplines within specific business lines. * Strong verbal and written communication skills. * Good analytical ability and mathematical aptitude. * Good attention to detail and organizational skills. * Ability to gather and analyze information, then determine and implement the appropriate course of action. * Good interpersonal skills. * Licensing as required by state and local jurisdictions. * Additional continuing education as required by Crawford Educational Services and as applicable for jurisdictions in which claims are adjusted or investigated.

Global Operations (Global Ops) focuses on creating positive experiences for MetLife customers and helping the company make the best use of its global resources. We're looking for unique talent with fresh perspectives that can propel innovation. In this role you will provide exemplary customer service by facilitating Multi-State Paid Family Leave (PFL) benefits, Family Medical leave Act (FMLA) and Americans with Disabilities Act (ADA) claim adjudication in a timely and accurate manner. Location: Must live within a commutable distance of the Oriskany, NY, Tampa, FL, Bloomfield, CT Cary, NC, Aurora, IL, Bridgewater, NJ, Omaha, NE, Warwick, RI, Clark Summit, PA, San Juan, PR, West Des Moines, IA office Once a month in office for meetings How You'll Help Us Build a Confident Future (Key Responsibilities) * Coaches, coordinates, and develops Multi-State PFL, FML and ADA Claims Specialists. * Acts as resources for claim-related and technical issues. * Monitors case managers' work queues to ensure claims team is meeting expectations and applicable performance guarantees. * Conducts exceeds authority reviews daily, weekly quality audits; resolves escalated phone calls. * Analyzes trending opportunities to provide ongoing trainings. * Provides real time coaching to Claims Specialists. * Provides feedback to Unit Leaders on individuals' and overall team performance. * Daily and weekly reporting to ensure compliance measures are met. * Performs other related duties as assigned or required. What You Need to Succeed (Required Qualifications) * Positive mindset and willingness to learn. * 1+ years of Disability Insurance experience. * Must be able to communicate clearly and effectively, both written and verbal. * Ability to work with autonomy, minimal direction. * Strong computer skills (word, excel, manipulating reports, spreadsheets, etc…). * High School Diploma. What Can Give You an Edge (Additional Skills) * 1+ years of Paid Family Leave experience. * 5+ years of Disability Insurance experience. * Excellent analytical, decision making and problem-solving skills. * Highly self-motivated. The expected salary range for this position is $41,600 - $61,500. This role may also be eligible for annual short-term incentive compensation. All incentives and benefits are subject to the applicable plan terms. Benefits We Offer Our U.S. benefits address holistic well-being with programs for physical and mental health, financial wellness, and support for families. We offer a comprehensive health plan that includes medical/prescription drug and vision, dental insurance, and no-cost short- and long-term disability. We also provide company-paid life insurance and legal services, a retirement pension funded entirely by MetLife and 401(k) with employer matching, group discounts on voluntary insurance products including auto and home, pet, critical illness, hospital indemnity, and accident insurance, as well as Employee Assistance Program (EAP) and digital mental health programs, parental leave, volunteer time off, tuition assistance and much more! About MetLife Recognized on Fortune magazine's list of the "World's Most Admired Companies", Fortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companies to Work For, MetLife, through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East. Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by our core values - Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead - we're inspired to transform the next century in financial services. At MetLife, it's #AllTogetherPossible. Join us! MetLife is an Equal Opportunity Employer. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law ("protected characteristics"). If you need an accommodation due to a disability, please email us at accommodations@metlife.com. This information will be held in confidence and used only to determine an appropriate accommodation for the application process. MetLife maintains a drug-free workplace. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liabilities. $41,600 - $61,500

** At Western Digital, our vision is to power global innovation and push the boundaries of technology to make what you thought was once impossible, possible. At our core, Western Digital is a company of problem solvers. People achieve extraordinary things given the right technology. For decades, we've been doing just that-our technology helped people put a man on the moon and capture the first-ever picture of a black hole. We offer an expansive portfolio of technologies, HDDs, and platforms for business, creative professionals, and consumers alike under our Western Digital , WD , WD_BLACK, and SanDisk Professional brands. We are a key partner to some of the largest and highest-growth organizations in the world. From enabling systems to make cities safer and more connected, to powering the data centers behind many of the world's biggest companies and hyperscale cloud providers, to meeting the massive and ever-growing data storage needs of the AI era, Western Digital is fueling a brighter, smarter future. Today's exceptional challenges require your unique skills. Together, we can build the future of data storage. **Job Description** ESSENTIAL DUTIES AND RESPONSIBILITIES + Work cross-functionally between Technical Support, Supply Chain, Pricing, Legal, and Product Marketing organizations within company to meet customers' needs + Manage the relationship with the account - including contract manufacturers, distributors, and end customer + Drive customer revenue and shipments to the goals of the account and company + Manage the internal and external communication regarding the account, making sure there is alignment and consistency within WD and externally to the customer Is available, responsive, and timely to customer inquiries, requests for information and/or quotations, problem resolution, etc - even if after normal business hours. + Coordinate customer pricing and rebate communication, and ensure correct rebates are paid on time to the customers + Manage the product lifecycle by account: product list, product roadmap, product launch, qualification, End of Life Schedule and host various technology and business meetings on weekly & quarterly basis + Manage meeting preparation, including creating pre-meeting document and scheduling pre-meeting for internal review and alignment prior to facing the customer + Manage meeting logistics including travel for customer engagements Map customer relationships and identify areas for improvement Manage historical and current revenue, PB, and unit shipment data for the account **Qualifications** REQUIRED + Bachelor's degree in a related field + 5-7 years of account management experience or equivalent experience. + Understand market conditions and how they affect WD and the customer + Understand the customer legal contracts and terms in place + Understand the supply chain process from WD to the end customer, identify areas of concern as they arise, and escalate when necessary SKILLS + Exceptional customer service and communication skills, with the ability to explain complex technical concepts to all levels of users. + Strong problem-solving and analytical skills. + Proven troubleshooting skills in customer-facing environments. + Strong desire and ability to learn new products and technologies. **Additional Information** Western Digital is committed to providing equal opportunities to all applicants and employees and will not discriminate against any applicant or employee based on their race, color, ancestry, religion (including religious dress and grooming standards), sex (including pregnancy, childbirth or related medical conditions, breastfeeding or related medical conditions), gender (including a person's gender identity, gender expression, and gender-related appearance and behavior, whether or not stereotypically associated with the person's assigned sex at birth), age, national origin, sexual orientation, medical condition, marital status (including domestic partnership status), physical disability, mental disability, medical condition, genetic information, protected medical and family care leave, Civil Air Patrol status, military and veteran status, or other legally protected characteristics. We also prohibit harassment of any individual on any of the characteristics listed above. Our non-discrimination policy applies to all aspects of employment. We comply with the laws and regulations set forth in the "Know Your Rights: Workplace Discrimination is Illegal (************************************************************************************** " poster. Our pay transparency policy is available here (*********************************************************************************************** . Western Digital thrives on the power and potential of diversity. As a global company, we believe the most effective way to embrace the diversity of our customers and communities is to mirror it from within. We believe the fusion of various perspectives results in the best outcomes for our employees, our company, our customers, and the world around us. We are committed to an inclusive environment where every individual can thrive through a sense of belonging, respect and contribution. Western Digital is committed to offering opportunities to applicants with disabilities and ensuring all candidates can successfully navigate our careers website and our hiring process. Please contact us at jobs.accommodations@wdc.com to advise us of your accommodation request. In your email, please include a description of the specific accommodation you are requesting as well as the job title and requisition number of the position for which you are applying. Based on our experience, we anticipate that the application deadline will be 1/16/2025 (3 months from posting), although we reserve the right to close the application process sooner if we hire an applicant for this position before the application deadline. If we are not able to hire someone from this role before the application deadline, we will update this posting with a new anticipated application deadline. **Compensation & Benefits Details** + An employee's pay position within the salary range may be based on several factors including but not limited to (1) relevant education; qualifications; certifications; and experience; (2) skills, ability, knowledge of the job; (3) performance, contribution and results; (4) geographic location; (5) shift; (6) internal and external equity; and (7) business and organizational needs. + The salary range is what we believe to be the range of possible compensation for this role at the time of this posting. We may ultimately pay more or less than the posted range and this range is only applicable for jobs to be performed in California, Colorado, New York or remote jobs that can be performed in California, Colorado and New York. This range may be modified in the future. + If your position is non-exempt, you are eligible for overtime pay pursuant to company policy and applicable laws. You may also be eligible for shift differential pay, depending on the shift to which you are assigned. + You will be eligible to be considered for bonuses under **either** Western Digital's Short Term Incentive Plan ("STI Plan") or the Sales Incentive Plan ("SIP") which provides incentive awards based on Company and individual performance, depending on your role and your performance. You may be eligible to participate in our annual Long-Term Incentive (LTI) program, which consists of restricted stock units (RSUs) or cash equivalents, pursuant to the terms of the LTI plan. Please note that not all roles are eligible to participate in the LTI program, and not all roles are eligible for equity under the LTI plan. RSU awards are also available to eligible new hires, subject to Western Digital's Standard Terms and Conditions for Restricted Stock Unit Awards. + We offer a comprehensive package of benefits including paid vacation time; paid sick leave; medical/dental/vision insurance; life, accident and disability insurance; tax-advantaged flexible spending and health savings accounts; employee assistance program; other voluntary benefit programs such as supplemental life and AD&D, legal plan, pet insurance, critical illness, accident and hospital indemnity; tuition reimbursement; transit; the Applause Program; employee stock purchase plan; and the Western Digital Savings 401(k) Plan. + **Note:** No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. **Notice To Candidates:** Please be aware that Western Digital and its subsidiaries will never request payment as a condition for applying for a position or receiving an offer of employment. Should you encounter any such requests, please report it immediately to Western Digital Ethics Helpline (******************************************************************** or email ****************** .

The person in this position acts as the main contact between the parts department of Ricardo Caballero Grupo Automatize and the different suppliers, and supplies the parts needs to the service department, as well as with retail and wholesale customers in the sale of parts and accessories for cars under the MITSUBISHI brand. He carries out all part transactions such as sale, shipping, receipt, return, among others. Responsibilities: Executes work assigned by the Parts & Service Manager. Inspects daily inventory and ensures that there is always an inventory of all parts to meet customer and service department needs. Keeps a record of the part or accessory orders placed and identifies in the system who owns each one and coordinates the delivery with the client or the appointment with the advisor. Keep the areas assigned to store parts clean, orderly and in good condition. Create new areas as needed and not have pieces on the floor that obstruct the passage. In charge of performing “Scrapping” and complying with the standard. Is responsible for keeping parts in the assigned area properly organized. Dispatch parts to the customer through the counter and to the workshop through the workshop window. Promote the installation of parts sold over the counter and refer it to the Service Advisor. Responsible for ordering parts complying with the standards of each brand. Estimates parts over the counter and for repairs in the workshop, whether warranty or paying customer, and will follow up on them. Ensure that you receive all the parts that are ordered and that they are in perfect condition. Responsible for communicating with the supplier when parts do not meet standards, or the ordered quantity is not received. Maintains contact with suppliers for order status or part returns. Document all delivery of special tools to technicians. Know the MITSUBISHI brand parts policies and procedures manual to comply with the brand's standards, including obsolescence. Make efforts to get new clients, whether regular or wholesale. Work as a team providing support to colleagues. Participate in seminars and training courses, whether online or in person, and do your best to acquire new skills. Follows up with advisors on uninstalled parts in inventory. Carry out other activities if requested by your supervisor. Know Service Advisor processes and guarantees to cover if necessary. Requirements: High School Diploma Valid Driver's License required. Basic knowledge of the use of dangerous objects and the risks. Basic knowledge of vehicle diagnosis. Knowledge of physical inventory, obsolescence, parts movements. Basic knowledge of safety in the work area. Basic reading and writing skills to understand repair orders and document work performed or needed. Knowledge of MITSUBISHI brand vehicles preferably and everything related to the development of the parts department. Ability to lift boxes of merchandise. Knowledge of information systems. Good verbal and written communication Kind of position: Full time, Indefinite contract Benefits: Professional development training. Private medical insurance Uniform provided Christmas Bonus Schedule: From Monday to Saturday One day off during the week and on Sundays Job Location: Face-to-face employment *Equal Employment Opportunities

Job Description You can become a Kevane Grant Thornton University Representative. We are accepting resumes for our talent database. The University Representatives: Represent the firm in the campuses. Deliver the firm's key messages to the universities and identify talented candidates. Maintain a close relationship with the professors and student's organizations to promote the firm. Principal Function: The University Representative is responsible for assisting the Human Resources Department in increasing and improving the exposition of the Firm in their respective universities and throughout accounting students. The incumbent must demonstrate skills such as: leadership, ethical conduct, self-confidence, excellent interpersonal communication, and familiarization with the Firm environment. Educational Background: The incumbent must comply with the following requirements: Enrolled in a bachelor's degree program in accounting of any university and coursing his/her second year, preferably. Having a 3.30 GPA or more on a scale of 4.00. This average should be maintained during the years of studies. Active member of the Accounting Students Association. Fluent in English and Spanish, written and oral. Kevane Grant Thornton is proud to be an Equal Employment Opportunity and Affirmative Action employer. The Company's policy is not to unlawfully discriminate against any applicant or employee on the basis of race, color, sex, religion, sexual orientation, gender identity, gender expression, national origin, age, disability status, genetic information, military or veteran status or any other applicable legally protected considerations made unlawful by federal, state, or local laws.

Diploma Escuela Superior completado. Esta vacante requiere experiencia previa en ventas y servicio al Cliente. Es reponsable de inventario, mantener exhibidores limpios y organizados. Realiza tareas afines al puesto. Conocimiento en uso de computadoras. Se reporta a tienda en Vieques $10.50+ Comision **Pay Details:** $10.50 per hour Benefit offerings available for our associates include short-term disability and additional voluntary benefits including medical, dental, vision, life insurance, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave and Vacation Leave or any other paid leave required by Federal, State, or local law where applicable. Equal Opportunity Employer/Veterans/Disabled Military connected talent encouraged to apply To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to ********************************************** The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable: + The California Fair Chance Act + Los Angeles City Fair Chance Ordinance + Los Angeles County Fair Chance Ordinance for Employers + San Francisco Fair Chance Ordinance

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 Specialty Loss Adjuster **Embark on an Exciting Career Journey with Sedgwick Specialty** **Job Location** **: USA, Mexico, Brazil and strategic locations globally** **Job Type** **: Permanent** **Remuneration** **: Salaries can range from** **_$40,000.00USD to $250,000.00USD_** **taking into account skills, experience and qualifications.** **We have a number of fantastic opportunities for Specialty Loss Adjusters across the US, Mexico and Brazil and a number of key locations** We are looking for a variety of skill sets at all levels. Whether you have just started your career, you are a leader in the industry, or a claims management expert looking for a new challenge, this is your chance to showcase your skills and grow with a company that values innovation, excellence, and employee satisfaction. Are you ready to be a part of providing a differentiated and best of class proposition to clients whilst working with like-minded colleagues? Sedgwick Specialty is thrilled to announce that we are investing in growth across Natural Resources, Property, Casualty, Technical and Special Risks and Marine. As we expand our operations, we are seeking individuals who are passionate about making a difference to the Adjusting industry. **As a member of the Specialty platform, you will have the opportunity to:** + Work with a wide range of clients across the globe, handling complex cases and claims + Collaborate with a talented and supportive team of professionals who are dedicated to delivering exceptional results + Utilise state-of-the-art technology and resources to streamline processes and enhance efficiency + Receive ongoing training and development opportunities to further enhance your skills and knowledge in the marine industry + Enjoy a flexible work arrangement that allows you to maintain a healthy work-life balance while contributing to our global success **The skills you will have when you apply:** + **Qualified** : it is important to us that you are either accredited, on your way to be accredited or qualified by experience + **Insurance claims experience:** it is imperative that you have experience working on insurance claims within you respective field. Full claims life cycle experience is a must + **Great communicator:** you will be constantly working with policy holders, brokers, carriers and various third parties, so being able to communicate accurately important. Providing an excellent customer service with our clients in mind. Able to approach issues empathetically + **Commercially minded:** An understanding of how the industry operates and where the role of a Loss Adjuster fits in. Being able to negotiate. Understanding how to market your services is a big advantage **What we'll give you for this role:** 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 annual salaries can range from _$40,000.00 to $250,000.00USD._ Bonus eligible role. 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. **This isn't just a position, it's a pivotal role in shaping our industry** At Sedgwick, you won't just build your career; you'll cultivate a team of experts. Our Sedgwick University offering empowers you to excel as well as your team members, with the most comprehensive training program in the industry which includes more than 15,000 courses on demand, training specific to roles, and opportunities to continue formal education. Together, we're not only reshaping the insurance landscape, we're building a legacy of talent. Come and be a catalyst for change within our industry. **Next steps for you:** **Think we'd be a great match? Apply now -** ** we want to hear from you.** As part of our commitment to you, we are proud to have a zero tolerance policy towards discrimination of any kind regardless of age, disability, gender identity, marital/ family status, race, religion, sex or sexual orientation. After the closing date we will review all applications and may select some applicants for an interview (which may be virtual, or in-person). \#LI-HYBRID 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**

Role Purpose The Accident and Health Claims Adjuster is responsible for the review, assessment, and management of A&H claims in a timely, fair, and accurate manner, ensuring compliance with policy terms, regulatory requirements and customer service standards.. Key Responsibilities • Review and analyze A&H claims to determine coverage and eligibility under policy terms. • Communicate with policyholders, brokers, healthcare providers, and internal stakeholders to obtain necessary information and provide claim updates. • Make timely decisions on claim approval, partial payment, or denial with clear justifications. • Identify potential fraudulent claims and refer cases as necessary for investigation. Requirements • Bachelor's Degree in Business Administration. • Adjusters License from the Office of the Commissioner of Insurance of Puerto Rico (OCS). • Demonstrated experience and/or knowledge in claims related to the following coverage's: Accident, Medical Expenses, Cancer, Critical Illnesses, Disability, Hospitalization, and SINOT, among others including policy interpretation. • High attention to detail and accuracy. • Ability to manage multiple claims and meet deadlines. • Demonstrate flexibility and adaptability to work in a fast moving and challenging environment. • Proficient in MS Applications (Word, Excel and Power Point). • Intermediate knowledge of the structure and content of the English and Spanish Language. Experience • Three (3) years of experience managing all major aspects of A&H claims adjustment process in the insurance industry, preferable.

College degree or an equivalent combination of education and experience. Minimum 2 years insurance adjusting experience with experience in each of at least two lines of business (casualty, property, or marine). Personal computer, typing and keyboarding skills In-depth knowledge of insurance coverage, practices and negotiating skills in multiple lines of business. Familiarity with legal, medical and technical disciplines within specific business lines. Strong verbal and written communication skills. Good analytical ability and mathematical aptitude. Good attention to detail and organizational skills. Ability to gather and analyze information, then determine and implement the appropriate course of action. Good interpersonal skills. Licensing as required by state and local jurisdictions. Additional continuing education as required by Crawford Educational Services and as applicable for jurisdictions in which claims are adjusted or investigated. College degree or an equivalent combination of education and experience. Minimum 2 years insurance adjusting experience with experience in each of at least two lines of business (casualty, property, or marine). Personal computer, typing and keyboarding skills In-depth knowledge of insurance coverage, practices and negotiating skills in multiple lines of business. Familiarity with legal, medical and technical disciplines within specific business lines. Strong verbal and written communication skills. Good analytical ability and mathematical aptitude. Good attention to detail and organizational skills. Ability to gather and analyze information, then determine and implement the appropriate course of action. Good interpersonal skills. Licensing as required by state and local jurisdictions. Additional continuing education as required by Crawford Educational Services and as applicable for jurisdictions in which claims are adjusted or investigated. #LI-CB3 Investigate coverage, liability, and damages with all parties involved in a claim as requested by our customers or Crawford and Company or a subsidiary thereof. Investigate claims by interviewing claimants, witnesses, establish claim reserves, handle evidence, obtain and interpret official reports, medical reports and claim forms, and attend/participate at mediation, trials or hearings. Negotiates and settles claims, sets reserves, and manages litigation within client service parameters and authority levels by obtaining demands and making offers to claimants. May present evidence at legal proceedings. Provide filings with regulatory agencies, disposing of salvage and pursuing subrogation when appropriate. Prepare reports by collecting and summarizing information required by the client and obtained through investigation. Self starter capable of working alone or with others. Maintains company reputation and insurance product integrity by complying with Federal and state regulations, client and Crawford and Company service standards. Maintain expected case loads in multiple lines of business while meeting established service delivery, production, quality, sales and educational objectives. May be required to work on-call during off work hours to respond to emergency on-site investigations. Maintain professional and technical knowledge through continuing education in multiple lines of business. Maintain acceptable product quality through compliance with service standards and compliance with internal quality control initiatives. Uphold and project the corporate image by participating in industry organizations and functions. Ability to multi-task in a time sensitive environment and handle job responsibilities with a sense of urgency. Participates in special projects or performs duties in other areas as requested. Upholds the Crawford Code of Conduct.

Location: Must live within a commutable distance of the Oriskany, NY, Tampa, FL, Bloomfield, CT Cary, NC, Aurora, IL, Bridgewater, NJ, Omaha, NE, Warwick, RI, Clark Summit, PA, San Juan, PR, West Des Moines, IA office Once a month in office for meetings How You'll Help Us Build a Confident Future (Key Responsibilities) * Coaches, coordinates, and develops Multi-State PFL, FML and ADA Claims Specialists. * Acts as resources for claim-related and technical issues. * Monitors case managers' work queues to ensure claims team is meeting expectations and applicable performance guarantees. * Conducts exceeds authority reviews daily, weekly quality audits; resolves escalated phone calls. * Analyzes trending opportunities to provide ongoing trainings. * Provides real time coaching to Claims Specialists. * Provides feedback to Unit Leaders on individuals' and overall team performance. * Daily and weekly reporting to ensure compliance measures are met. * Performs other related duties as assigned or required. What You Need to Succeed (Required Qualifications) * Positive mindset and willingness to learn. * 1+ years of Disability Insurance experience. * Must be able to communicate clearly and effectively, both written and verbal. * Ability to work with autonomy, minimal direction. * Strong computer skills (word, excel, manipulating reports, spreadsheets, etc...). * High School Diploma. What Can Give You an Edge (Additional Skills) * 1+ years of Paid Family Leave experience. * 5+ years of Disability Insurance experience. * Excellent analytical, decision making and problem-solving skills. * Highly self-motivated. Equal Employment Opportunity/Disability/Veterans If you need an accommodation due to a disability, please email us at accommodations@metlife.com. This information will be held in confidence and used only to determine an appropriate accommodation for the application process. MetLife maintains a drug-free workplace.

Diploma Escuela Superior completado. Esta vacante requiere experiencia previa en ventas y servicio al Cliente. Es reponsable de inventario, mantener exhibidores limpios y organizados. Realiza tareas afines al puesto. Conocimiento en uso de computadoras. Se reporta a tienda en Carolina $10.50+ Comisión **Pay Details:** $10.50 per hour Benefit offerings available for our associates include short-term disability and additional voluntary benefits including medical, dental, vision, life insurance, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave and Vacation Leave or any other paid leave required by Federal, State, or local law where applicable. Equal Opportunity Employer/Veterans/Disabled Military connected talent encouraged to apply To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to ********************************************** The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable: + The California Fair Chance Act + Los Angeles City Fair Chance Ordinance + Los Angeles County Fair Chance Ordinance for Employers + San Francisco Fair Chance Ordinance

College degree or an equivalent combination of education and experience. Minimum 2 years insurance adjusting experience with experience in each of at least two lines of business (casualty, property, or marine). Personal computer, typing and keyboarding skills In-depth knowledge of insurance coverage, practices and negotiating skills in multiple lines of business. Familiarity with legal, medical and technical disciplines within specific business lines. Strong verbal and written communication skills. Good analytical ability and mathematical aptitude. Good attention to detail and organizational skills. Ability to gather and analyze information, then determine and implement the appropriate course of action. Good interpersonal skills. Licensing as required by state and local jurisdictions. Additional continuing education as required by Crawford Educational Services and as applicable for jurisdictions in which claims are adjusted or investigated. Responsibilities Investigate coverage, liability, and damages with all parties involved in a claim as requested by our customers or Crawford and Company or a subsidiary thereof. Investigate claims by interviewing claimants, witnesses, establish claim reserves, handle evidence, obtain and interpret official reports, medical reports and claim forms, and attend/participate at mediation, trials or hearings. Negotiates and settles claims, sets reserves, and manages litigation within client service parameters and authority levels by obtaining demands and making offers to claimants. May present evidence at legal proceedings. Provide filings with regulatory agencies, disposing of salvage and pursuing subrogation when appropriate. Prepare reports by collecting and summarizing information required by the client and obtained through investigation. Self starter capable of working alone or with others. Maintains company reputation and insurance product integrity by complying with Federal and state regulations, client and Crawford and Company service standards. Maintain expected case loads in multiple lines of business while meeting established service delivery, production, quality, sales and educational objectives. May be required to work on-call during off work hours to respond to emergency on-site investigations. Maintain professional and technical knowledge through continuing education in multiple lines of business. Maintain acceptable product quality through compliance with service standards and compliance with internal quality control initiatives. Uphold and project the corporate image by participating in industry organizations and functions. Ability to multi-task in a time sensitive environment and handle job responsibilities with a sense of urgency. Participates in special projects or performs duties in other areas as requested. Upholds the Crawford Code of Conduct. Qualifications College degree or an equivalent combination of education and experience. Minimum 2 years insurance adjusting experience with experience in each of at least two lines of business (casualty, property, or marine). Personal computer, typing and keyboarding skills In-depth knowledge of insurance coverage, practices and negotiating skills in multiple lines of business. Familiarity with legal, medical and technical disciplines within specific business lines. Strong verbal and written communication skills. Good analytical ability and mathematical aptitude. Good attention to detail and organizational skills. Ability to gather and analyze information, then determine and implement the appropriate course of action. Good interpersonal skills. Licensing as required by state and local jurisdictions. Additional continuing education as required by Crawford Educational Services and as applicable for jurisdictions in which claims are adjusted or investigated. #LI-CB3

Role Purpose The Accident and Health Claims Adjuster is responsible for the review, assessment, and management of A&H claims in a timely, fair, and accurate manner, ensuring compliance with policy terms, regulatory requirements and customer service standards.. Key Responsibilities • Review and analyze A&H claims to determine coverage and eligibility under policy terms. • Communicate with policyholders, brokers, healthcare providers, and internal stakeholders to obtain necessary information and provide claim updates. • Make timely decisions on claim approval, partial payment, or denial with clear justifications. • Identify potential fraudulent claims and refer cases as necessary for investigation. Qualifications Requirements • Bachelor's Degree in Business Administration. • Adjusters License from the Office of the Commissioner of Insurance of Puerto Rico (OCS). • Demonstrated experience and/or knowledge in claims related to the following coverage's: Accident, Medical Expenses, Cancer, Critical Illnesses, Disability, Hospitalization, and SINOT, among others including policy interpretation. • High attention to detail and accuracy. • Ability to manage multiple claims and meet deadlines. • Demonstrate flexibility and adaptability to work in a fast moving and challenging environment. • Proficient in MS Applications (Word, Excel and Power Point). • Intermediate knowledge of the structure and content of the English and Spanish Language. Experience • Three (3) years of experience managing all major aspects of A&H claims adjustment process in the insurance industry, preferable.

Diploma Escuela Superior completado. Esta vacante requiere experiencia previa en ventas y servicio al Cliente. Es reponsable de inventario, mantener exhibidores limpios y organizados. Realiza tareas afines al puesto. Conocimiento en uso de computadoras. Se reporta a tienda en San German $10.50+ Comisión **Pay Details:** $10.50 per hour Benefit offerings available for our associates include short-term disability and additional voluntary benefits including medical, dental, vision, life insurance, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave and Vacation Leave or any other paid leave required by Federal, State, or local law where applicable. Equal Opportunity Employer/Veterans/Disabled Military connected talent encouraged to apply To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to ********************************************** The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable: + The California Fair Chance Act + Los Angeles City Fair Chance Ordinance + Los Angeles County Fair Chance Ordinance for Employers + San Francisco Fair Chance Ordinance

Diploma Escuela Superior completado. Esta vacante requiere experiencia previa en ventas y servicio al Cliente. Es reponsable de inventario, mantener exhibidores limpios y organizados. Realiza tareas afines al puesto. Conocimiento en uso de computadoras. Se reporta a tienda en Canóvanas $10.50+ Comisión **Pay Details:** $10.50 per hour Benefit offerings available for our associates include short-term disability and additional voluntary benefits including medical, dental, vision, life insurance, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave and Vacation Leave or any other paid leave required by Federal, State, or local law where applicable. Equal Opportunity Employer/Veterans/Disabled Military connected talent encouraged to apply To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to ********************************************** The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable: + The California Fair Chance Act + Los Angeles City Fair Chance Ordinance + Los Angeles County Fair Chance Ordinance for Employers + San Francisco Fair Chance Ordinance

Diploma Escuela Superior completado. Esta vacante requiere experiencia previa en ventas y servicio al Cliente. Es reponsable de inventario, mantener exhibidores limpios y organizados. Realiza tareas afines al puesto. Conocimiento en uso de computadoras. Se reporta a tienda en Cupey $10.50+ Comisión **Pay Details:** $10.50 per hour Benefit offerings available for our associates include short-term disability and additional voluntary benefits including medical, dental, vision, life insurance, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave and Vacation Leave or any other paid leave required by Federal, State, or local law where applicable. Equal Opportunity Employer/Veterans/Disabled Military connected talent encouraged to apply To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to ********************************************** The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable: + The California Fair Chance Act + Los Angeles City Fair Chance Ordinance + Los Angeles County Fair Chance Ordinance for Employers + San Francisco Fair Chance Ordinance