Remote Claims Quality & Compliance Auditor

Sedgwick; Orlando (FL); Teletrabalho; USD 50 000 - 70 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical, dental, vision

401k and matching

PTO

Disability and life insurance

Employee assistance

Flexible spending or Health Savings

Resumo da oferta

Sedgwick is seeking a Performance Assurance Analyst to monitor claims colleague technical activities at a file level, focusing on identifying and interpreting trends in compliance by conducting audits and recommending training to management.

The role covers quality program administration, presenting audit results to leadership, supporting TPM initiatives, coaching colleagues, and maintaining jurisdictional expertise.

Qualificações

• Bachelor's degree from an accredited college or university preferred; professional certification in a specialty field preferred.
• High school diploma or GED required.
• Six years of claims experience or equivalent combination of education and experience required, including one year of claims auditing experience.

Responsabilidades

• 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 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.

Conhecimentos

Claims management

Quality auditing

Communication

Data analysis

Problem solving

Organization

Interpersonal skills

Teamwork

PC literacy

Formação académica

Bachelor's degree

High school diploma or GED

Descrição da oferta de emprego

Sedgwick is seeking a Performance Assurance Analyst to monitor claims colleague technical activities at a file level, focusing on identifying and interpreting trends in compliance by conducting audits and recommending training to management.

The role covers quality program administration, presenting audit results to leadership, supporting TPM initiatives, coaching colleagues, and maintaining jurisdictional expertise.