Sedgwick Claims Management Services Employee Reviews

Found 287 reviews matching the search
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I loved the people at this company as well as my clients but the work load and expectations were UNREALISTIC. Work life balance non existant
Claims Examiner III (Former Employee) –  Cola SCOctober 3, 2013
A typical day was constantly putting out fire after fire that was left or created by a prior handler of my account. I would handle new claims regarding contacts and investigation protocols as a priority; then I would check all of my daily set diaries of work and complete these, once those were completed I would work at least 10 pieces of my mail per day and complete all reports that were jurisdictionally required to avoid penalties. Returned phone calls to medical providers for authorizations; plaintiff counsels and negotiations would be done as well. I learned a lot in my time with Sedgwick as I became familiar with various Workers' Compensation Laws for more than my specialty state SC. Prior to my leaving I had learned NC, KY, GA very well; I handled AR, AL as well as FL however I was not as knowledgeable in those three states regarding the laws as I was with SC, NC, GA & FL. I was housed in the Cola office and my co-workers were wonderful people; I still keep in contact with them. I actually brought two employees over to the company who are still there in order to obtain two more years of employment to fully retire. The hardest part of this job is the fact that Sedgwick "Best Practice guidelines" are absolutely ridiculous to comply with. The Account Managers that were actually obtaining the Clients for us make unreasonable promises to the Clients without even considering that the Examiners that are responsible for fulfilling the tasks have absolutely no input. Basically the company has all Indemnity Examiners handling accounts as though the Examiner is a "Dedicated Examiner"  more... to that particular account ONLY. In one instance I was advised that I was NOT to tell my client that they were NOT MY ONLY CLIENT. This makes me appear to not be doing my job when I am actually handling several other accounts up to at least 3 and many multiple jurisdictions... So in other words the clients are completely in the dark about exactly how much work the Company has their Examiner handling and therefore the Client expectations are NOT being met and the Client doesn't understand why. The Examiner is being the fall guy. I disagreed with this and therefore this is ultimately why I decided after giving it a year of working 60 and 80 hours a week and a lot of the times working 7 days a week and having been given an account that had not been properly worked for over a year; I saw that there was not going to be any change on the behalf of the way the Examiners were being treated. This was a struggle because I REALLY loved so many things about the company but I have a family and could not continue to be married to this company. The most enjoyable part of this job is the fact that I was challenged mentally on a daily basis (which I LOVE) I was NEVER bored at times I would actually work through lunch and not even realize it. I personally am a type "A" personality and therefore a work horse. I really liked the constant work that the company offered and I absolutely adored every person that I met with the company. They have a lot of great people that I truly miss.  less
Pros
nice work atmosphere; a lot of continued education programs
Cons
there is absolutely no work life balance; you have to be married to the company or you will drown
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Horrible (not customer service)
service center representative (Former Employee) –  Dubuque, IAOctober 16, 2014
They are the worst call centers I have worked at. They treat you like doo doo. Also, they have a resource that they call an “Assist Line”, where people can “help” you through tougher questions with employees (the people who generally call in). This “Assist Line” has people whom don’t know what they are doing. I have been wrote-up for things that this “Assist Line” has told me. The assist line people never get reprimanded. Also, the examiners (people who you are the liaison to), never get reprimanded either. The examiners (most, but not all) are mean and don’t help these employees. Basically, your job is being a glorified answering service for people whom are confused and mad that they can’t get their money. You receive a lot of training, none of which helps to soften the blow of the upset employees. You are given loads of information that you can’t tell the employees. You are required to talk in circles until they give up. There are many times that I wanted to help out the employees, but couldn’t, cause the rules and regulations (which are many), prevent you from doing so. I hated this job, because I like helping people. This should NOT be listed as a customer service job, rather customer necessity. If you have worked for Walmart, Starbucks, Kohls, General Mills, Comcast, Delta Airlines, Apple, Sisters of St. Francis Hospitals(Franciscan alliance), ConAgra, Sun Trust Banks, Childerns hospitals of Wisconsin, e-bay, LabCorp, etc.(a lot of large companies) and haven’t received benefits, it is probably because the person on the other end of the line was prevented in telling you  more... this information, most likely because Sedgwick doesn’t do anything they aren’t specifically paid to do. Also, those who train you, don’t know how to do your job or weren’t properly trained their selves(yeah, doesn’t make sense, does it?). I had a team lead that was so uninformed, every question I asked, she had to run across the call center to relay the questions. Finally, the QAs (monitorings) are not standardized and vary greatly from QA person to QA person. They nit-pick everything (spelling is like 10 points) and they don’t help you to learn. Overall, the company is a bureaucratic (insert curse word, cause I want this posted) that you should pray you avoid.  less
Cons
too many to list
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Better management at McDonald's
RN case manager for workers compensation (Former Employee) –  TNJuly 12, 2014
Nurse case manager for workers' comp:

* Caseload of 80-90 (standard caseload is 55-60). Typical work week is 60-70 hours and paid for 37.5. Many nurses came in on weekends and stayed late to avoid being written up.
* Paid twice a month with high deductible insurance.
*Toxic environment ruled by bullying, fear, and intimidation.
*Nursing in all 50 states required without regard to whether or not you have the nursing license in that state.
*You will need to know state rules and regulations and good luck in finding the the information you need to process the claims.
*High turnover of nurses. Over 50 % yearly. Easy to get fired, and most quit within first few months. Many nurses I worked with were on disability due to the high stress and poor management.
*Monthly audits are subjective. If you do something to upset management or if they don't like you, you can be certain it will show up on your next audit. If they really don't like you, or if you don't agree with them and voice your opinion, you will be placed on a performance plan and they will begin the process to fire you.
*Instead of training you to do the job, they will blame you for not knowing what to do. I have seen nurses placed on performance plans because they were never taught the job. (This is most likely to take the focus off of management's ineptness).
*Too many supervisors, and most aren't qualified. Managers for managers.
*Once you are established there, YOU become the enemy. I have never been treated so poorly, and I have never seen nurses treated so poorly, anywhere, ever.
*Micromanagement - every second of your
  more... time will be accounted for. I have seen them remote into computers for the entire day to see what someone else is doing.
*There is no legitimate HR. The girl that works in HR is *only* for management.
*I'm curious as to why the CEO has not done anything to challenge the current structure of nursing that isn't working, and the high turnover. Maybe they don't want to know. COMPANY EVALUATIONS are NOT ANONYMOUS.
Worst management I've experienced in ANY job. EVER.
  less
Cons
micromanagement, poor management, no raises
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Pharmacy RN-Poor training---did not feel like Nursing!
Pharmacy RN (Former Employee) –  Richmond, Va.February 1, 2015
This job was not at all what I thought it would be after my interview. Told would be helping patients decrease their pain meds and avoid addiction. Wow--sounded great huh? When you begin work you are hardly trained AT ALL on the complicated computer systems--plural! Trainers fly in to teach but even they are confused regarding the system and disagree with each other during training! No physician is going to change their orders because some telephonic nurse tells them to. Also required to contact claims examiners who talk to the nurses like dirt--no respect at all--very rude--when nurses complain to administration about the rude CEs they are given NO support and told to accept the rude behavior--who becomes a nurse for that??!! Not rewarding--just evaluated on how many cases you can do for billing! But not even instructed during training on how to do it! Totally $$ focused. Also--about 2 weeks after so-called training--you find you quickly have 50--then 150 cases assigned to you!! One of the trainers stayed in the office most of the time and told us to come ask her any questions because she had to still work on her 250 cases while she was expected to train us in Virginia!! Ridiculous. Several quickly quit that job and others are looking to find other jobs! All true--hope I can help someone else not have to go through the same thing--or at least be prepared for the real job. Also--cubicles are NOT sound buffering at all--I mean it is very hard to concentrate when staff are so loud on the phones all around you. Very distracting. We were told could use headphones to help decrease  more... office noise.  less
Pros
pretty building! good pay and benefits. thats about it.
Cons
too numerous to mention. read review.
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hit or miss management
loa coordinator (Current Employee) –  coralville iaOctober 27, 2013
I've worked here for about 6 months. I thought the training was pretty good. I like what I do (process leave of absence claims for one of the largest companies in the world). One problem though is there is more work then can be done in a day. At least not if you want to produce work that is of any kind of quality. Often I feel as if management treats staff like children. If overtime is available you have to ask if you can work OT. If you are 'allowed' to work OT, you have to keep record of everything you accomplished during OT. You are treated as if you have no integrity, even though that's supposed to be a company value. Quality of management is hit or miss. I know of people who have been told by their manager that they "ask too many questions". And most questions are answered with "did you use your resources?" The problem with "using your resources" is that not every situation that arises could possibly be written in a step process or basic fmla manual. Communication is also an issue here. Policies and processes change and a quarter of the staff is told about it and the rest of us are unaware. Also they give you 5 weeks of PTO but then say you can't use it unless your work is caught up, which is nearly impossible. They've only started to allow OT because employees were being told that they were expected to have all of their work done in a day but were also told they weren't going to be paid OT to do it. So people were working off the clock. At least that practice has stopped.
Pros
compensation, pto
Cons
management, unmanageable workload
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Heavy call volume and stressful.
Customer Service Representative (Former Employee) –  Calabasas, CAOctober 19, 2012
I really enjoyed the challenge of helping people who had no experience is disability benefits. They were often nervous, even scared, because they thought using their disability benefits was a sign that they were doing something wrong or deceiving. Sometimes they were hostile because they had preconceived ideas about their benefits and how they should be handled. Education and patience were necessary for this job, but most importantly it was empathy that made them satisfied. They wanted to be comforted, assured and guided. I got a great deal of satisfaction in helping them feel empowered and so did the clients. The company should have invested in compassionate communication as part of the job training. I actually took a course outside of the workplace to become better in my job. Everyone benefited.

With high call volume, there is a lot of pressure to keep calls within the company's expectations. If the calls take longer to resolve a supervisor does a review with the employee as an "issue" regardless of how well the call was handled to completion. Sometimes it takes longer to actually ensure customer satisfaction than what is allowed. Pity.

Management support and trainig were limited to mini "training" sessions that turned out to be performance evaluations which is later used in annual evaluations and affects the employee's overall score.
Pros
weekly hours 37.5. good benefit package including ample vacation time.
Cons
training and management.
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Sweat Shop
RN Case Manager (Former Employee) –  CaliforniaNovember 17, 2012
This company is a sweat shop with no regard for the product they are selling and that product is the employee providing the service to the client. The only thing good about this company is the sales team. They are very good at selling a product that does not exist. They are only interested in making a press statement so they can sign up more accounts with unsuspecting clients. The case loads for the employees are so high that you cannot possibly provide the service Sedgwick is selling. Their pay scale is low for the amount of work expected. They are big on micromanagement and developing programs for nurses and claims examiners to add to their already extremely high case loads. The charting expectations are off the map, out of control and designed and redesigned by an upper management team trying to justify their own jobs. Their charting expectations have little to do with the real goals. They are perfunctory tasks designed by some upper level nurse or administrator to make themselves look good and to keep their high paying jobs. The employees in the trenches are the best! Everything else about this company is a disingenuous promise trying to close deals behind closed doors. The core values of this company are a joke and are also words provided only for selling a broken promise to the company out there needing a TPA. Run from this company! Life is too short!
Pros
benefits are fine
Cons
poor upper management, dishonesty in the community, dishonesty with their employees.
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Great Company, Great Benefits, Great Job advancement opportunities
LOA Representative - 3 yrs (Current Employee) –  Pasadena, CAJuly 16, 2014
Great Company, Great Benefits, Great Job advancement opportunities. Ive had the opportunity to advance my knowledge on state and federal regulations; company policies and the coordination of benefits and how it works.

Management is great on a personal and work level. However, would be nice if they were open for suggestions or idea on how to improve the workflow in order to meet expectations on a more timely and efficient manner.

The hardest part of the job is meeting these expectations. The expectations are simple and easy to meet if given a reasonable, manageable caseload. With the amount of open cases and the requirements of our client(s), an additional examiner would be helpful in order to meet the required exceptions without having to pay out so much overtime.

The coworkers are great. We operate as one company, one team and with integrity. Their always willing to offer one another help if or when their able to.

The most enjoyable part of the job is the relationship built between myself and my claimant and/or my client. Being able to assist in every way possible in order to make things easier for them during a difficult time in their life. At the end of a hard days work, receiving their verbal appreciation makes it all worth it!
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Run, do not walk, away from Sedgwick!
Worker Bee (Former Employee) –  Chicago, ILSeptember 8, 2013
Let me tell you about a company where you are hired as a "virtual employee" (boss isn't present) and the boss NEVER bothers to meet you in 1 1/2 years! Where a VP is allowed to make sexual innuendos to you but you can't do anything about it. Where your group is actually run by a long-tenured employee - who has no education beyond high school and is allowed to show up at the facility just whenever she feels like it! Where the claims supervisor spends more time smoking on the deck outside than actually helping her people. Where smart, eager people are driven out because you might be a threat to other people. Where you can't talk to anyone about the problems there because HR naturally assumes that the employee is the problem!
You do not want to work for these people. They will lie to you, abuse you, make you doubt your experiences and sanity and then throw you out when they think you might actually have a valid complaint! You will NEVER get a promotion (4-5 layers of job assures that) and you will never get a raise. You 'might' get a nice Christmas dinner. These people almost drove a sane person to a nervous breakdown. Run away. This is the worst toxic environment I have ever seen.
Pros
nice enough office environment
Cons
management, no observance of eeoc, watching them deny valid claims every day and steal from people.
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Difficult place to work
Disability Specialist (Former Employee) –  Irving, TXMay 25, 2013
Sedgwick has potential to be a good company, but is selfish with its employees and money hungry. They expect you to be punctual and present everyday which is typical but they do not monitor what time you go home. Most days supervisors were long gone before the regular employees. There is too much micro-management and most managers tend to pass the buck when a simple correction can be made by them. Instead they would rather take the time to send you an email to correct something than do it themselves. Also the email was not an educational reason why it needed correction just a criticism to fix it. Lastly the pay is salary, and most days it was more than an 8 hour day of work. They were critical about the employees being there on time (which I was usually 15 min early everyday) and present everyday and was hassle trying to get time off. Although the managers came and went as they pleased and of coarse had no issues taking time off even during the holidays or high load days or weeks.
Would I go back? Sure the job is a piece of cake, but the pay would have to be hourly!
Pros
benefits are good, great break room and pleasent people
Cons
work load and hours worked, issues getting time off, too much micro-management, and salary pay
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Audited different claims systems, completed audit reports and presented findings and action plans to management.
Internal Auditor (Former Employee) –  Troy, MIMay 15, 2013
Completed testing of claims processes, presented management with the findings during the testing process to complete the action plans, documented audit system with results.

Using multiple claims systems required the ability to understand how to capture and review the claims for completing the audits timely. This was a great learning process and I managed to be successful on all systems.

Management was very supportive when working with local management and getting action plans completed.

Co-workers were very helpful and made the job enjoyable when things got hectic or if there were questions that required clarification.

Hardest part of the job traveling for 3 1/2 months on one specific project and going home every other week.

Auditing presented the greatest learning of the company's culture, processes, management that could not have been attained if I was not presented with this opportunity.
Pros
great learning experience to gain knowledge of the company
Cons
new audit documenting systems were introduce and kept changing without adequate training.
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Professional, fast paced, deadline driven work environment
Workers Compensation Assistant Claims Examiner (Current Employee) –  Pleasanton, CAJuly 10, 2013
Sedgwick CMS is a professional environment, dedicated to meeting their core values at every level of the organization. They are a third party administrator of workers' compensation, liability and short term disability benefits with high standards.

I have been employed with the organization for 11 years as an Assistant Claims Examiner.

A typical day involves completing daily tasks associated with the specific requests of the claims examiners I assist, making phone calls, referrals for services to vendors, operating general office machinery, utilizing industry specific computer programs and software and problem solving individual matters that may arise throughout the day.

Hardest part of my day may include the short turnaround required for rush assignments or making sure that I am doing all I can to keep customers and injured workers happy.

The most enjoyable part of my day is building professional relationships with our clients, injured workers and associated vendors.
Pros
stability, professional, and supportive staff
Cons
salary and benefits
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Great company to work for, but unfortunately they had a lot of layoffs in the past few months.
Senior Administrative Assistant (Former Employee) –  Rancho Cordova, CAJuly 15, 2012
- Arrive at my workstation / greet my supervisor and cube neighbors / turn on computer / check my daily calendar and to-do list / get some coffee / open and review all new e-mails and determine priorities / check my physical inbox and open and review any mail received / start my work process making sure to tackle priority items first / eat lunch / continue working until closing time or even work overtime if needed.
- Learned about spreadsheet management / Workers' Comp case handling procedures / all the intricate aspects of a multi-tasking administrative assistant/claims assistant position.
- Had a wonderful supervisor with whom I worked for almost 20 years.
- Friendly and helpful co-workers
- Hardest part of the job: cannot think of anything specific!
- Most enjoyable part of my job: was able to work independently with very minimal supervision and got a lot of praise for work well done!
Pros
flexible hours; great benefits; very comfortable and enjoyable working environment
Cons
was laid off despite continuous excellent performance reviews and 20+ years of seniority
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Comment – November 17, 2012

This company is about acting as if they are the best TPA in the United States. They make promises to their clients that they really cannot live up to. The Employees have extremely high case loads with unrealistic expectations and the added benefit of heavy micromanagement. The employees can not fulfill the promises Sedgwick makes to their clients. Therefore they are doing their client a disfavor and they are lying just to get the account. Their pay scale is very low and they are dishonest in the promises made to both the clients and to the employees. No wonder they removed the CMS from their name. To much bad press. The sales team is excellent at presenting empty promises and that is the only thing good about this company other than the employees....Run for your life because life is too short to work for a company like this. It is a sweat shop with no respect for the product they are selling and that product is the employee giving the service. The best TPA in the country?? It is all a smoke screen.. They do not live up to their disingenuous core values. Their core values are as empty as their promises.

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Not very respectful and expect to much from their employees.
Claims Examiner (Current Employee) –  Nashville, TNMay 14, 2013
This company provides very little and inadequate training. The expected case load for all lost time adjusters 175 claims and you have to make your own payments, send out checks and do your own state forms. Three of the states handled in this office are VERY FORM heavy.

The new claims management system is redundant and as a lot of intricacies that slow the adjuster down by trying to figure out what box has to be checked on a certain screen in order to issue a check. Yet very little help is provided by management.

This is a very stressful work environment with very little help offered in the way of release.

There have been four adjusters leave the Nashville TN office within the last 45 to 60 days and none of them are being replaced. All of their claims are expected to be absorbed by the current adjusters.

The morale in the office is also not very good and most people I know are looking for other opportunities like the the four people who recently left.

I would not recommend anyone to come and work here.
Pros
they do allow vendors to bring in goodies and we can wear jeans
Cons
see comments below
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FUN PLACE TO BE-COMPANY CARES FOR A JOB WELL DONE
Service Center Representative (Former Employee) –  Coralville, IAJuly 13, 2014
I personally loved my job with Sedgwick; but, after 1 year I noticed in the Call Center TLs didn't seem to treat all Colleagues the same, some discrimination was noticeable and this wasn't the way it should've been. I feel everyone should be treated the same. And even, thou those are just some of my personal feelings, I would still say the company in itself is fine to become a part of. I honestly, miss my co-workers and a few of the TLs. The Colleagues work very well as a team and as an individual you can get the sense of a family setting. Management is AWESOME. I enjoyed speaking with the Callers and Managers. It was an experience I would never forget. And as we were trained "EMBRACING CHANGE" was not a challenge for me; but, a true experience. The most enjoyable moment for me was watching how our team stuck together, worked together, shared feelings, tears, laughter, and helped each other with calls when necessary. Our team and TL is the GREATEST of ALL TIMES. CORALVILLE, IOWA TEAM ROCKS!!!!
Pros
free tea and coffee every morning and awesome benefit package
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Nice people to work with / but need more work life balance
Disability Representative, Sr (Current Employee) –  Eden Prairie, MNMay 18, 2014
you start your day looking at a to do list
you have 3 of them, list for contact, emails, and faxes

you have inbound calls that you take all day long from clients and updated them on a claim that you are working on for them

you read, and document all medical , then take action to update the file in the computer system

you are for the most part on your own to make the correct decision based on the incoming medical

your management is their for support if needed , you attend meetings on line and in conference rooms several times a week

I work part from home and in the office

I like that I have freedom to work from home and the office
and the benefit package. Nice time out if you can use it.

for the most part the people that I work with are enjoyable

but the least enjoyable of my job is the work life balance, over worked in the amount of claims that we process and when you or your team mates leave on vacation and someone is always on vac. its over whelming.
Pros
benefit package
Cons
work life balance
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Great Pay, Friendly Environment
Customer Service Representative (Current Employee) –  Southfield, MIAugust 15, 2014
Call Center Environment. Heavy call flow Mondays, moderate call flow for rest of the week. Good Experience learning basic skills in claims management for STD/FMLA, training in the Sedgwick University is available, which is training resources you can use, when applying for other positions, Great opportunities to move up, they do a lot of hiring within, so you could get a promotion 6months - 1yr after being hired.

Not so good on time, only PTO, and those days are based on your years of service, no sick/vacation pay, you have to notify HR 24hrs in advance to use a PTO day, which they can deny base on service levels, they will deny PTO days if were are not meeting our percentage mark on a Monday for example. Time schedules are not flexible, you have to do shift bids for good shifts. You can't have more than 2 call offs in a year.

Pay is good starting at 13-14 hourly.

Great people to work with, offers at home positions once hired in, we have company outings which are nice, in a nice facility
Cons
schedule, shifts
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Sweatshop/Crash and Burn
RN Case Manager (former employee) (Former Employee) –  PortlandJune 1, 2013
You will receive low pay and no raises, and you will be working 60+ hours just to keep up with an impossible caseload. You will be audited 4 times a month and if you don't pass, you will be written up. They will also have you do "other projects" such as pharmacy reviews that will take hours outside your caseload to complete. Licensing is another nightmare. You will be required to complete dozens of licenses on your own time. Management is inept, arrogant, and out of touch. Turnover for nurses and adjusters is high and the company doesn't care. The high stress of this job will take a toll on your health and family life. Taking this job was the worst career choice I've ever made in nursing. Don't' walk from this job, run. I honestly don't know how they stay in business with such a high turnover of staff. They don't produce what they are promising the client, but perhaps the client isn't checking into things.
Pros
free coffee
Cons
low pay, high stress, micro management, poor training, bad benefits
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Tense environment with incompetent supervisors.
CE II / Workers Compensation (Current Employee) –  Greenwood Village, COOctober 10, 2013
A typical day at Sedgwick includes working an impossible claims load with no administrative or clerical support. Adjustors get audited numerous times per month and any perceived problem, no matter how small or insignificant results in getting berated by management. The custom policies that are written for difficult clients make promises that cannot be kept. It is a "throw you under the bus" mentality toward adjustors. Management blames their own incompetence on claim reps. Do not work here if you value your self esteem. This job will ruin your family life and caused major depression. There is a rash of adjustors taking the 13 week FMLA leave with notes from their doctor claiming too much stress to work. These employees are not replaced and no temps are called in. The remaining adjustors are forced to pick up the slack.
Pros
flex hours, good pay, good benefits.
Cons
cannot use your pto as there is no backup. too much stress.
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Secure, permanent job with Day 1 Full Benefits
Service Center Representative (Current Employee) –  Orlando, FLOctober 28, 2015
Overall, this is a very sound and stable company. There is much room for growth. But just like any company, it comes with its particular set of work politics. I think there is favoritism shown when you're trying to apply for an internal job within your location. That's just my opinion. But that's the only negative thing I have to say.

Once you start training, you are medically covered! It's a beautiful thing! I've referred ppl to apply and I have 4 of my friends hired here so far. For every person that is successfully hired through our colleague referral program, you receive $500 after they complete 6 months of employment. Of course it is taxed before you get it but it's more money in your pocket still. I started at $14.33/hr as a Service Center Rep. so the pay is good too. Towards the end of the year going into the new year, OT is offered more and it may be unlimited to rack up and save.
Pros
Good pay and benefits
Cons
minor favoritism
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3.2
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