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
Technical Standards and Compliance Advisor
PRIMARY PURPOSE : 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.
ESSENTIAL FUNCTIONS and 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.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
Workers compensation and/or liability claims background preferred.
Travels as required.
QUALIFICATIONS
Education & Licensing
Bachelor's degree or equivalent from an accredited college or university preferred.
Experience
Ten (10) years of claims management and/or other related experience or equivalent combination of education and experience required.
Skills & Knowledge
In depth knowledge of regulatory claims management, managed care and/or absence management processes and procedures
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
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 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
NOTE : Credit security clearance, confirmed via a background credit check, is required for this position.
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 $60,000- $65,000 . 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.
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.
Taking care of people is at the heart of everything we do. Caring counts
Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)
