Claims Compliance Auditor | Dedicated Client | Liability & Auto experience prefe

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

Experience

Five (5) years claims management experience or equivalent combination of education and experience required. Two (2) years of service with the company preferred. Liability and Auto experience preferred. Workers Compensation a plus.

No Licensing required

PRIMARY PURPOSE: To monitor claims colleague technical activities at a claim file level by conducting audit with a focus on identifying issues to ensure compliance with best practices.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Conducts office file audits using the Compass tool.
• Presents audit results to management.
• Recommends training and improvement activities needed to meet established operational and technical audit requirements.
• Participates in national quality review meetings.
• Maintains technical claims and jurisdictional expertise.
• Conducts colleague training.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.
• Supports the organization's quality program(s).
• Travels as required.

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred. Professional certification (i.e. AIC, CPCU or ARM) preferred.

Experience

Five (5) years claims management experience or equivalent combination of education and experience required. Two (2) years of service with the company preferred.

Skills & Knowledge

• Thorough knowledge of claims management practices and procedures
• Strong understanding of quality and auditing process
• Excellent oral and written communication, including presentation skills
• PC literate, including Microsoft Office products
• Leadership/management/motivational skills
• Analytical and interpretive skills
• Strong organizational skills
• Excellent interpersonal skills
• Ability to work in a team environment
• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical: Computer keyboarding, travel as required

Auditory/Visual: Hearing, vision and talking

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

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.

Originally posted on Himalayas