Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?  

• Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. 
• Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations. 
• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. 
• Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights. 
• Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. 
• Enjoy flexibility and autonomy in your daily work, your location, and your career path. 
• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. 

ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

PRIMARY PURPOSE OF THE ROLE: Responsible for ensuring quality standards for a specific client, including adherence to service instructions and reserve protocols; conducting client-specific audits; monitoring audit compliance; and resolving issues in collaboration with Quality and Operations teams.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Ensure adherence to client service instructions and timely distribution of claims reports.
• Monitor client reserves and average claim costs; identify trends and excessive cost factors.
• Track performance guarantees and gain share agreements at the client level.
• Conduct operational audits and monitor client compliance.
• Manage internal control report issues and resolve client concerns in collaboration with Quality and Operations teams.
• Oversee timely payments for TTD, medical, and vendor bills; ensure appropriate vendor utilization.
• Review aging claims to prevent delays in file closure.
• Perform other duties as assigned.
• Support the organization’s quality programs.

QUALIFICATIONS

Education & Licensing: 8 years of claims management experience or equivalent combination of education and experience required. 5 years of claims management and 2 years of auditing experience. One year of continuous service with the company is preferred

• High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred. 
• Professional certification as applicable to line of business preferred.

TAKING CARE OF YOU

• Flexible work schedule. 
• Referral incentive program. 
• Career development and promotional growth opportunities. 
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

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 ($90,000 - $105,000). 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.