Performance Assurance Analyst

Sedgwick; Cincinnati (OH); Remote; USD 65,000 - 88,000; Full time

Job summary

Sedgwick is seeking a Performance Assurance Analyst to perform extensive quality reviews of personal and commercial line claims, ensuring adherence to client guidelines and company standards. You’ll review files up to $300,000 using Xactimate and Symbility, identify non-compliance trends, and coordinate with teams on improvements in a remote setting across multiple states.

The position emphasizes training, audit best practices, and detailed written reporting, supporting Sedgwick’s quality

Qualifications

• Five years of related experience, including three years in claims handling
• Three years at an advanced technical level as a file reviewer of personal and commercial claims
• Experience with personal and commercial lines claims and quality/audit processes
• Ability to learn virtual meeting and collaboration tools

Responsibilities

• Executes the quality assurance program by completing quality reviews of Personal and Commercial Lines claim files using Xactimate and Symbility with varying degree of severity (up to approximately $300,000)
• Interprets policy and client guidelines on personal and commercial lines claims to ensure compliance
• Guides field colleagues on revisions as required to ensure compliance with client guidelines and company standards
• Completes revisions as required via Xactimate and/or Symbility as appropriate
• Documents review findings in accordance with team processes
• Identifies and provides training and improvement opportunities to the Team Lead to meet established operational and technical audit requirements
• Coordinates with the Analyst Team in implementing Sedgwick business unit (SBU) and national quality initiatives
• Provides feedback to the Team Lead to contribute to the performance management review meetings and group training
• Maintains technical claims handling and estimating and jurisdictional expertise

Skills

Quality assurance

Claims handling

Xactimate

Symbility

Communication skills

Microsoft Office

Analytical skills

Organizational skills

Remote work

Team player

Education

Bachelor's degree

Tools

Xactimate

Symbility

Microsoft Office

Job description

Telecommuter TX

Telecommuter FL

Telecommuter OH

Telecommuter WI

Telecommuter IA

Full time

R78749

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

Performance Assurance Analyst

PRIMARY PURPOSE :

Performs comprehensive reviews on personal and commercial lines claims of varying degree of severity (up to approximately $300,000) to ensure the highest quality of work product is delivered to our clients; confirm our adjuster’s claim files comply with specific client handling guidelines and company standards; and identifies trends in non-compliance to recommend training opportunities that exist.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Executes the quality assurance program by completing quality reviews of Personal and Commercial Lines claim files using Xactimate and Symbility with varying degree of severity (up to approximately $300,000).
• Interprets policy and client guidelines on personal and commercial lines claims to ensure compliance.
• Guides field colleagues on revisions as required to ensure compliance with client guidelines and company standards.
• Completes revisions as required via Xactimate and/or Symbility as appropriate.
• Documents review findings in accordance with team processes.
• Identifies and provides training and improvement opportunities to the Team Lead to meet established operational and technical audit requirements.
• Coordinates with the Analyst Team in implementing Sedgwick business unit (SBU) and national quality initiatives at the local and/or SBU level.
• Provides feedback to the Team Lead to contribute to the performance management review meetings and group training, as needed.
• Maintains technical claims handling and estimating and jurisdictional expertise.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.
• Travel as required

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred. Must be eligible to be a licensed All-Lines adjuster. Completion of industry-related training course(s) preferred.

Experience

Five (5) years of related experience, to include three (3) years of claims handling, including three (3) years at an advanced technical level as a file reviewer of personal and commercial claims, or equivalent combination of education and experience required.

Skills & Knowledge

• Strong knowledge of claims handling and file review practices and procedures
• Versed in quality and auditing processes
• Proficient in electronic estimating using Xactimate or Symbility
• Excellent oral and written communication skills, including presentation skills
• PC literate, including Microsoft Office products and digital resources
• Analytical and interpretive skills
• Strong organizational skills
• Ability to learn how to navigate virtual meeting, screen sharing, and collaboration applications
• Self-motivated with an ability to thrive in a remote work environment
• Excellent interpersonal skills
• Ability to create and complete comprehensive, accurate and constructive written reports
• 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.

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