Performance Assurance Analyst - Sedgwick Claims Management Services, Inc.

PRIMARY PURPOSE:  To monitor claims colleague technical activities at a claim file level with a focus on identifying and interpreting trends in compliance by conducting audits, identifying areas of concern and to recommend appropriate areas for training to management.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Administers the quality program; conducts local office file audits using the Compass tool
• Presents audit results to local, regional and national management as requested.
• Assists Total Performance Manager in coordinating and implementing Sedgwick business unit (SBU) and national quality initiatives at the local and/or SBU level.
• Recommends training and improvement activities needed to meet established operational and technical audit requirements.
• Participates in colleague coaching, mentoring and group training as needed.
• Participates in quarterly national total performance management (TPM) review meetings with national TPM and Quality leaders.
• Maintains technical claims and jurisdictional expertise.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

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

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred. Professional certification (i.e. AIC, CPCU or ARM) preferred.

Experience

Six (6) years of related experience or equivalent combination of education and experience required to include three (3) years of claims management experience at an advanced technical level. Two (2) years’ service with Company preferred. Must have Workers Compensation experience

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 Competencies

WORK ENVIRONMENT

When 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 deadlines

Physical:  Computer keyboarding, travel as required

Auditory/Visual:  Hearing, vision and talking.

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.