Performance Assurance Analyst

Sedgwick; Miami (FL); Remote; USD 50,000 - 70,000; Full time

Benefits offered by this job

Medical benefits

401k and matching

PTO

Disability insurance

Life insurance

Employee assistance

Job summary

Sedgwick is seeking a Performance Assurance Analyst to monitor claims activities, audit files, and identify trends in compliance. This role emphasizes training and quality improvement across local, regional, and national levels.

You will administer the quality program, present audit results, coordinate TPM initiatives, mentor colleagues, and maintain technical claims expertise. Travel may be required. Competitive benefits apply.

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.
• 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

Communication skills

Data analysis

Problem solving

Organization

Interpersonal skills

Team player

PC literacy

Education

Bachelor's degree preferred

High school diploma or GED required

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:

To monitor claims colleague technical activities at a claim file level with a focus on identifying and interpreting trends in compliance by conducting audits, identifying areas of concern and to recommend appropriate areas for training to management.

ESSENTIAL FUNCTIONS and 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.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

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

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred. Professional certification in a specialty field preferred.

High school diploma or GED required.

Experience

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.

Skills & Knowledge

• 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

WORK ENVIRONMENT

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

Mental :

Clear cognitive functioning; ability to make decisions; ability to perform detailed work; ability to maintain concentration, alertness and attention.

Physical :

Computer keyboarding; visual acuity.

Auditory/Visual:

Hearing, near and far vision.

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.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $50,000.00 - $70,000.00 USD Annual. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

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