About The Position

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Technical Standards & Compliance Advisor l OR Workers Compensation Required l Remote OR, WA, CA 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? 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: To ensure product quality and compliance with regulatory requirements and serve as a resource to office operations with a focus on achieving timely and accurate delivery of benefits and notices to mitigate penalties and legal claim exposures and other adverse actions.

Requirements

  • Bachelor's degree or equivalent from an accredited college or university preferred.
  • Ten (10) years of claims management and/or other related experience or equivalent combination of education and experience required.

Responsibilities

  • Develops and reviews management reports related to claim processes or decisions that are subject to legal and regulatory compliance.
  • Develops training programs and technical support material to monitor and prevent legal and regulatory claim handling exposures. Consults with Sedgwick University as needed in the development and delivery of training programs consistent with these objectives.
  • Participates in round table review of claim strategy and makes recommendations that are consistent with legally compliant file handling standards.
  • Assists with projects focused on process, procedural and/or compliance changes/updates; may be involved in the communication of changes/updates to field offices, IT, Legal and other applicable business units.
  • Prepares offices for regulatory audits, participates in debriefings as needed, and assists in the development of rebuttal positions. Acts as a liaison to state auditors and operations.
  • Educates colleagues, managers and/or clients regarding state regulatory matters and assist with the resolution of regulatory/compliance issues.
  • Works closely with internal quality programs and practice leads to share information and prepares mitigation strategies.
  • Ensure consistent adoption of required forms, procedures and legally compliant practices by all business unit offices.
  • Performs other duties as assigned.
  • Supports the organization's quality program(s).
  • Travels as required.

Benefits

  • Flexible Work Schedule
  • Referral Incentive Program
  • Opportunity to work from home
  • Career development and promotional growth opportunities
  • A diverse and comprehensive benefits offering including medical, dental vision, 401K on day 1
  • 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 ($73,000 - $90,000). 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
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