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Quality Assurance – Claims Compliance Auditor

Sedgwick Claims Management Services, Inc.

This is a Full-time position in Dallas, TX posted June 6, 2021.

The ‘Apply with SEEK’ option will be utilized for International applicants, mainly Australia. If this does not apply to you please use the ‘Apply’ option.Quality Assurance – Claims Compliance AuditorIF YOU CARE, THERE’S A PLACE FOR YOU HEREFor a career path that is both challenging and rewarding, join Sedgwick’s talented team of 27,000 colleagues around the globe. Sedgwick is a leading provider of technology-enabled risk, benefits and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. Whether they have a workplace injury, suffer property or financial loss or damage from a natural or manmade disaster, are involved in an auto or other type of accident, or need time away from work for the birth of a child or another medical situation, we are here to provide compassionate care and expert guidance. Our clients depend on our talented colleagues to take care of their most valuable assets-their employees, their customers and their property. At Sedgwick, caring counts®. Join our team of creative and caring people of all backgrounds, and help us make a difference in the lives of others.PRIMARY PURPOSE: To monitor claims colleague technical activities at a claim file level by conducting audit with a focus on identifying issues to ensure compliance with best practices.ESSENTIAL FUNCTIONS and RESPONSIBILITIES* Conducts office file audits using the Compass tool.* Presents audit results to management.* Recommends training and improvement activities needed to meet established operational and technical audit requirements.* Participates in national quality review meetings.* Maintains technical claims and jurisdictional expertise.* Conducts colleague training.ADDITIONAL FUNCTIONS and RESPONSIBILITIES* Performs other duties as assigned.* Supports the organization’s quality program(s).* Travels as required.QUALIFICATIONSEducation & LicensingBachelor’s degree from an accredited college or university preferred. Professional certification (i.e. AIC, CPCU or ARM) preferred.ExperienceFive (5) years claims management experience or equivalent combination of education and experience required. Two (2) years of service with the company preferred.Skills & Knowledge* Thorough knowledge of claims management practices and procedures* Strong understanding of quality and auditing process* Excellent oral and written communication, including presentation skills* PC literate, including Microsoft Office products* Leadership/management/motivational skills* Analytical and interpretive skills* Strong organizational skills* Excellent interpersonal skills* Ability to work in a team environment* Ability to meet or exceed Performance CompetenciesWORK ENVIRONMENTWhen 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 deadlinesPhysical: Computer keyboarding, travel as requiredAuditory/Visual: Hearing, vision and talkingNOTE: Credit security clearance, confirmed via a background credit check, is required for this position.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.

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