Claims Quality & Compliance Analyst

Sedgwick; Austin (TX); Remote; USD 50,000 - 70,000; Full time

Job summary

Sedgwick is seeking a Performance Assurance Analyst to monitor claims activities, conduct audits, and identify trends to improve compliance. You’ll coordinate with management, support quality initiatives, and deliver training recommendations.

The role emphasizes strong communication, data analysis, and collaborative problem solving within a dynamic, remote-friendly environment. Eligible for a comprehensive benefits package and travel as needed.

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• High school diploma or GED required.
• Six (6) years of claims experience or equivalent combination of education and experience required, including one (1) year of claims auditing experience required or equivalent combination of education and experience.
• Strong knowledge of claims management practices and procedures.
• Strong understanding of quality and auditing processes.
• Excellent oral and written communication, including presentation skills.
• Strong analytical skills with the ability to interpret data.
• Problem-solving and negotiation skills.
• Excellent organizational skills.
• Excellent interpersonal skills.
• Ability to work in a team environment.
• Ability to use a personal computer.

Responsibilities

• Administers the quality program; conducts local office file audits using the Compass tool.
• Presents audit results to local, regional and national management as requested.
• Assists Total Performance Manager in coordinating and implementing Sedgwick business unit (SBU) and national quality initiatives at the local and/or SBU level.
• Recommends training and improvement activities needed to meet established operational and technical audit requirements.
• Participates in colleague coaching, mentoring and group training as needed.
• Participates in quarterly national total performance management (TPM) review meetings with national TPM and Quality leaders.
• Maintains technical claims and jurisdictional expertise.
• Performs other duties as assigned.
• Supports the organization's quality program(s).
• Travels as needed.

Skills

claims management

quality auditing

oral & written comms

analytical skills

problem solving

organizational skills

interpersonal skills

teamwork

computer skills

Education

Bachelor's degree

High school diploma or GED

Tools

Compass tool

Job description

Sedgwick is seeking a Performance Assurance Analyst to monitor claims activities, conduct audits, and identify trends to improve compliance. You’ll coordinate with management, support quality initiatives, and deliver training recommendations.

The role emphasizes strong communication, data analysis, and collaborative problem solving within a dynamic, remote-friendly environment. Eligible for a comprehensive benefits package and travel as needed.