Claims Audit & Compliance Specialist – Commercial Liability

Sentry Insurance • Stevens Point, WI

3d • Hybrid

About The Position

In this role, you will play a crucial part in safeguarding Sentry’s claims integrity and regulatory compliance. As a Claims Audit & Compliance Specialist – Commercial Liability, you will develop and execute detailed audit plans to evaluate the accuracy of claims processing, compliance with regulations, and adherence to organizational policies. You will work with internal stakeholders at various levels of claims management to address audit findings and implement corrective measures. You will maintain documentation and stay informed about industry regulations, best practices, and emerging trends.

Requirements

• Bachelors Degree or equivalent work experience
• Minimum 6 years of related work experience
• Technical expertise in regulatory analysis, claim processes, procedures, and laws
• Strong analytical, communication and presentation skills
• Ability to work with diverse groups and develop partnerships, teamwork, and good working relationships with all levels of external and internal business partners

Responsibilities

• Develop and implement comprehensive audit plans to assess claims processing accuracy, compliance with regulatory guidelines, and adherence to organizational policies.
• Analyze claims data and trends to identify potential areas for process improvement or risk mitigation.
• Complete daily/weekly control report reviews and investigate findings.
• Collaborate with internal stakeholders, including multiple levels of claims management, to address audit findings, implement corrective actions, and enhance claims processing efficiency.
• Develop and maintain audit documentation, reports, and metrics to track audit findings and outcomes.
• Stay updated on industry regulations, best practices, and emerging trends related to claims processing and compliance.
• Develop and maintain the letters used by associates in claims handling.
• Provide training and guidance to claims processing teams on compliance standards and audit protocols.

Benefits

• Sentry is happy to offer flexibility through a scheduled Hybrid work model. Monday and Friday work from home if you choose to, Tuesday through Thursday you’ll work in office.
• As a Sentry associate, you will have an in-office workspace and materials for your home office. In addition to the laptop, you will receive prior to your start, Sentry will provide equipment for your home office.
• Meal Subsidy available for associates who report to an office.
• 401(K) plan with a dollar for dollar match on your first eight percent, plus immediate vesting to help strengthen your financial future.
• Continue your education and career development through Sentry University (SentryU) and utilize our Tuition Reimbursement program
• Generous Paid-Time Off plan for you to enjoy time out of the office as well as Volunteer-Time off
• Group Medical, Dental, Vision, Life insurance, Parental leave, and our Health and Wellness benefits to encourage a healthy lifestyle.
• Well-being and Employee Assistance programs
• Sentry Foundation gift matching program to encourage charitable giving.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 501-1,000 employees