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Sedgwick Claims Management Services
Telecommuter, New Mexico, United States
(on-site)
Posted
1 day ago
Sedgwick Claims Management Services
Telecommuter, New Mexico, United States
(on-site)
Job Type
Full-Time
Quality Control Representative - Heavy Equipment/Specialty
The insights provided are generated by AI and may contain inaccuracies. Please independently verify any critical information before relying on it.
Quality Control Representative - Heavy Equipment/Specialty
The insights provided are generated by AI and may contain inaccuracies. Please independently verify any critical information before relying on it.
Description
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
Quality Control Representative - Heavy Equipment/Specialty
PRIMARY PURPOSE: The Quality Control Representative ensures accuracy, consistency, and compliance in Specialty claim files and processes. This role supports operational excellence through detailed audits and promotes continuous improvement across teams.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
- Review claim files for completeness, accuracy, and adherence to company and client-specific standards.
- Identify errors, inconsistencies, and opportunities for improvement; document findings.
- Ensure compliance with regulatory and client requirements
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
- Participate in special projects and process improvement initiatives.
- Assist with internal or external audit preparation as needed.
- Perform other duties as assigned.
QUALIFICATIONS
Education & Licensing
Bachelor's degree from an accredited college or university preferred.
Experience
- Minimum of 2 years in claims, auditing, or quality assurance.
- At least 1 year of appraisal experience or equivalent combination of education and experience.
- Experience in customer service or insurance environments preferred.
Skills & Knowledge
- Oral and written communication skills
- PC literate, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skills
- Ability to work independently or 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 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.
Requisition #: R68064
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Job ID: 81230029

Sedgwick Claims Management Services
Insurance
Tennessee
,
United States
Sedgwick Claims Management Services, Inc. (Sedgwick CMS) is the leader in innovative claims and productivity management solutions to major employers. Sedgwick CMS provides cost-effective claims administration, managed care, program management and related services through the expertise of 6,400 colleagues in more than one hundred and fifty offices and service locations in the U.S. and Canada.
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