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Sedgwick logo

Workers Compensation Client Performance Manager | Dedicated Client

Sedgwick

Salary Range

85k - 85k USD / YEAR

Job Summary

Sedgwick is seeking a Client Service Auditor to ensure quality aspects of client services, conduct audits, monitor compliance, and resolve issues. The ideal candidate has 8+ years of related experience, including 5+ years in claims management and 2+ years in auditing. They should possess excellent communication, analytical, and leadership skills, as well as the ability to work in a team environment. Sedgwick offers a comprehensive benefits package, flexible remote work options, and opportunities for growth and development. If you're driven to make a difference and enjoy a challenge, consider joining our team.

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. 

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to Work® Most Loved Workplace®  Forbes Best-in-State Employer

Workers Compensation Client Performance Manager | Dedicated Client | Remote

PRIMARY PURPOSE: To be responsible for the quality aspects of a specific client including client service instructions and reserves; to conduct client specific audits; to monitor client audit compliance; to resolve client issues by working with the company Quality and 0perations staff.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

  • Ensures adherence to client service instructions

  • Monitors client reserves for accurate reflection of client's book of claims; ensures reserves are within an appropriate range.

  • Tracks and trends performance guarantee and gain share agreements at the client level.

  • Ensures client's claims reports are properly and timely prepared and distributed.

  • Monitors client's average cost of claims; identifies trends and excessive cost factors.

  • Conducts client specific operational audits; monitors client audit compliance.

  • Works with company Quality and Operations staff to resolve client issues including results of client Compass audits.

  • Manages client specific internal control report issues.

  • Ensures timely payment of TTD, medical and vendor bills; ensures appropriate vendor utilization.

  • Reviews aging claims for file closure ensuring claims do not age beyond appropriate time frames.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

  • Performs other duties as assigned.

  • Supports the organization's quality program(s).

QUALIFICATIONS

Education & Licensing Bachelor's degree from an accredited college or university preferred.

Experience Eight (8) years of related experience or equivalent combination of education and experience required to include five (5) years of claims management and two (2) years of auditing experience. One (1) year of continuous service with the company is preferred.

Skills & Knowledge

  • Thorough knowledge of claims management practices and procedures

  • 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

  • Excellent negotiation 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.

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 ($85,000/yr). 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.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.