Performance Assurance Analyst

Sedgwick Claims Management Services; United States; Remote; USD 60,000 - 70,000; Full time

Benefits offered by this job

Medical benefits

401k matching

Paid time off

Job summary

Sedgwick is hiring a Performance Assurance Analyst to perform quality reviews of personal and commercial lines claims up to $300,000, ensuring compliance with client guidelines and company standards. The role includes guiding field colleagues, performing revisions in Xactimate or Symbility, and documenting findings to support ongoing quality initiatives.

Ideal candidates have a bachelor’s degree with at least five years in claims handling, strong communication skills, and the ability to work

Qualifications

• Bachelor's degree preferred or equivalent combination of education and experience.
• Five years of related experience including three years of claims handling and advanced technical file review.
• Strong knowledge of claims handling, auditing, and reviewing practices.

Responsibilities

• Perform quality assurance reviews of Personal and Commercial Lines claim files using Xactimate and Symbility.
• Interpret policy and client guidelines to ensure compliance.
• Guide field colleagues on revisions to meet client guidelines and standards.
• Complete revisions via Xactimate and/or Symbility as needed.
• Document review findings per team processes.
• Identify training opportunities and coordinate with Team Lead for performance improvements.
• Coordinate with Analyst Team on quality initiatives at local/SBU level.
• Provide feedback to Team Lead for performance reviews and trainings.

Skills

Claims handling

File review

Xactimate

Symbility

Communication skills

Analytical thinking

Organization

Remote work

Interpersonal skills

Education

Bachelor's degree

Tools

Xactimate

Symbility

Job description

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.

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 $60,000.00 - $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.