Quality & Compliance Audit Specialist

Sedgwick; United States; Remote; USD 50,000 - 70,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401k

PTO

Life insurance

Flexible benefits

Job summary

Sedgwick is seeking a Performance Assurance Analyst to monitor claims activities at the file level, audit quality, and identify trends for training. The role involves coordinating with management to implement quality initiatives, presenting results, and maintaining expertise in claims processes.

The position emphasizes strong communication, analytical skills, and collaboration within a team. A bachelor’s degree is preferred and candidates should have extensive claims experience.

Qualifications

• Six years of claims experience or equivalent combination of education and experience.
• One year of claims auditing experience or equivalent combination of education and experience.
• Strong knowledge of claims management practices and procedures.
• Excellent oral and written communication, including presentation skills.

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 TPM in coordinating and implementing Sedgwick quality initiatives at local and/or SBU level.
• Recommends training and improvement activities to meet audit requirements.
• Participates in coaching, mentoring and group training as needed.
• Participates in quarterly TPM review meetings with national TPM and quality leaders.
• Maintains technical claims and jurisdictional expertise.

Skills

Claims management

Quality auditing

Communication

Analytical

Problem solving

Organizational

Interpersonal

Team player

PC literacy

Education

Bachelor’s degree preferred

High school diploma or GED

Job description

Sedgwick is seeking a Performance Assurance Analyst to monitor claims activities at the file level, audit quality, and identify trends for training. The role involves coordinating with management to implement quality initiatives, presenting results, and maintaining expertise in claims processes.

The position emphasizes strong communication, analytical skills, and collaboration within a team. A bachelor’s degree is preferred and candidates should have extensive claims experience.