Claims Compliance Auditor - Workers Compensation

Sedgwick • Trenton, NJ

406d

About The Position

The Claims Compliance Auditor for Workers Compensation at Sedgwick is responsible for monitoring claims colleague technical activities at a claim file level through audits. The role focuses on identifying compliance issues with best practices and involves presenting audit results, recommending training, and maintaining technical expertise in claims management.

Requirements

• Bachelor's degree from an accredited college or university preferred.
• Professional certification (i.e. AIC, CPCU or ARM) preferred.
• Five (5) years claims management experience or equivalent combination of education and experience required.
• Two (2) years of service with the company preferred.
• 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 Competencies.

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.
• Performs other duties as assigned.
• Supports the organization's quality program(s).
• Travels as required.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• 401k and matching
• Paid Time Off (PTO)
• Disability insurance
• Life insurance
• Employee assistance program
• Flexible spending account or health savings account
• Other additional voluntary benefits

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree
• Number of Employees: 10,001+ employees