Workers Compensation Client Performance Manager - Dedicated Client - Remote

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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.

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. (***/watch?v=ywxedjBGSfA)