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.
Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected.

The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see

sedgwick.com

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