Workers’ compensation practice group

Sedgwick CMS’ dedicated workers’ compensation practice group oversees the continuous
improvement to our established best practices. This group of experienced colleagues analyzes new statutory or case law requirements and introduces changes to our work processes when necessary. They also work with our account management group to identify improvement opportunities and serve as an industry knowledge resource to Sedgwick CMS’ clients and internal teams.

Customization

Sedgwick CMS is dedicated to working with our clients to create customized solutions tailored to meet their individual claims objectives. Our experience and flexibility enables the adaptation of proven best practices to meet new challenges. One example of this capacity is our ability to create dedicated/designated adjuster staffing structures based in regional or local offices, thereby leveraging economies of scale through regional claims administration. We also base adjusters close to a client’s operations if necessary to assure compatibility with the client’s business structures.

Quality

Sedgwick CMS has developed a total performance management approach to quality that translates the vision and goals of our client partners into systems and tools that:

• Direct the efforts of our service professionals through alignment with specific client priorities
• Measure the effectiveness of performance by confirming the achievement of benchmarks that support client objectives and address gaps immediately as they occur
• Continuously enhance the performance of our colleagues through our national network of full time total performance managers

Sedgwick CMS’ total performance management approach to quality is emphasized daily through our dedicated total performance managers, the customized colleague portal, and Sedgwick CMS University Claims College.

Total performance managers

Sedgwick CMS has developed a network of dedicated quality specialists to work directly with our colleagues to provide the training, coaching, and problem-solving support necessary to ensure that quality is the primary focus of our claims management services. The total performance managers are stationed in offices across the country. Their objective is to monitor ongoing compliance with our best practices, measure trends, and provide meaningful feedback and training to our colleagues, ensuring continuous quality improvement.

Customized colleague portal

We developed a customized colleague portal that provides daily updates on job-critical information. The portal provides the following:

• Client-specific access to account service expectations
• Function-specific updates from practice leaders and account management
• Self-selected alerts on changes in service expectations and other job requirements
• Quick and easy access to all computer-based tools and resources within Sedgwick CMS
• Global company messages affecting all colleagues Sedgwick CMS University Claims College

Sedgwick CMS University Claims College, an internal training center, prepares new colleagues with identified high potential to play important roles in providing better outcomes for clients. The Claims College is our response to an industry-wide shortage of well trained, career-oriented claims professionals. We believe the Sedgwick CMS Claims College is unique among major third party administrators.

We have undertaken this challenge to invest in the development of colleagues who are just out of college or who have a few years of practical business experience in any field. In Phase One of their program, Claims College recruits attend a residential program designed to prepare them to step in an begin applying quality claims skills based on our high standards. All graduates receive intensive training and must pass a series of tests in order to graduate to Phase Two.

In Phase Two, participating colleagues move to the office in which they will be based. Phase Two, which lasts for three months, couples remote learning assignments and periodic testing with intensive mentoring of the Claims College participants. Most specific jurisdictional training is conducted in Phase Two. At this stage, trainees are assigned a light caseload that is gradually increased to full level under supervision of their mentor.

Upon completion of Phase Two of their training, colleagues are tested for mastery of Sedgwick CMS’ claims management best practices and industry knowledge. Trainees who successfully complete this test then move to increasing responsibilities and participate in an additional eight months of less intensive mentoring. Trainees who do not complete this rigorous program but demonstrate good work habits and a capacity for effective performance in entry level jobs may apply for available, positions matching their qualifications.

System support

Sedgwick CMS’ proprietary claims management system, JURIS ®, was designed to maximize flexibility, ease of use, and value of analysis for our colleagues and our clients. JURIS’ flexibility offers customized client service instructions and data fields, anticipating our clients’ needs regarding data capture. JURIS also has a robust reporting capability, anticipating our clients’ needs and expectations relative to data reporting. The JURIS system also incorporates a time tracking module, which gives us the ability to capture absence management data.

We also provide our clients with the ability to access their claims information online through our viaOne ® suite of services. Access can be provided as view-only, or clients can utilize the viaOne query function, which allows them to add to the notes and diaries to our adjusters and run standard and customized ad hoc reports.

Integration

The robust capabilities of the JURIS claims management information system give Sedgwick CMS the ability to integrate each of our product offerings, including workers’ compensation, liability, disability, and OSHA services, providing streamlined, seamless solutions to meet each of our clients’ risk management needs.

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