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Performance Assurance Analyst
at Sedgwick CMS in Illinois
Performance Assurance Analyst
CLAIM YOUR FUTURE AS A GREAT PERFORMER!
Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been voted the Best TPA in America for 2005 and 2006, and the first and only Third Party Administrator to receive the coveted Employer of Choice designation. Come be a part of our team and "Claim Your Future."
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
1.Administers the quality program; conducts local office file audits using the Compass tool
2.Presents audit results to local, regional and national management as requested.
3.Assists Total Performance Manager in coordinating and implementing Sedgwick business unit (SBU) and national quality initiatives at the local and/or SBU level.
4.Recommends training and improvement activities needed to meet established operational and technical audit requirements.
5.Participates in colleague coaching, mentoring and group training as needed.
6.Participates in quarterly national total performance management (TPM) review meetings with national TPM and Quality leaders.
7.Maintains technical claims and jurisdictional expertise.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
1.Performs other duties as assigned.
2.Supports the organization's quality program(s).
3.Travels as needed
QUALIFICATIONS
Education & Licensing
Baccalaureate degree from an accredited college or university preferred. Professional certification (i.e. AIC, CPCU or ARM) preferred.
Experience
Five (5) years related experience required to include three (3) years of claims management experience at an advanced technical level. Two (2) years service with Company is preferred.
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.
Sedgwick CMS is an Equal Opportunity Employer
and a
Drug-Free Workplace
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar:
http://sedgwickcms.contacthr.com/20742166
CLAIM YOUR FUTURE AS A GREAT PERFORMER!
Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been voted the Best TPA in America for 2005 and 2006, and the first and only Third Party Administrator to receive the coveted Employer of Choice designation. Come be a part of our team and "Claim Your Future."
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
1.Administers the quality program; conducts local office file audits using the Compass tool
2.Presents audit results to local, regional and national management as requested.
3.Assists Total Performance Manager in coordinating and implementing Sedgwick business unit (SBU) and national quality initiatives at the local and/or SBU level.
4.Recommends training and improvement activities needed to meet established operational and technical audit requirements.
5.Participates in colleague coaching, mentoring and group training as needed.
6.Participates in quarterly national total performance management (TPM) review meetings with national TPM and Quality leaders.
7.Maintains technical claims and jurisdictional expertise.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
1.Performs other duties as assigned.
2.Supports the organization's quality program(s).
3.Travels as needed
QUALIFICATIONS
Education & Licensing
Baccalaureate degree from an accredited college or university preferred. Professional certification (i.e. AIC, CPCU or ARM) preferred.
Experience
Five (5) years related experience required to include three (3) years of claims management experience at an advanced technical level. Two (2) years service with Company is preferred.
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.
Sedgwick CMS is an Equal Opportunity Employer
and a
Drug-Free Workplace
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar:
http://sedgwickcms.contacthr.com/20742166
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