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All Lines Claims Adjuster - Quality Assurance Specialist

Role overview

Summary

This role focuses on assessing and promoting data quality and performance of investigative service partners and internal resources at Sedgwick. You will conduct quality audits of case files to ensure compliance and optimal service delivery, working closely with stakeholders to enhance service efficiency.

Qualifications

  • Full adjusting license in one or more provinces
  • Minimum of four (4) years of investigative experience or equivalent combination of education and experience required.
  • Minimum five (5) years of claims adjusting experience
  • Strong background in adjusting auto and property claims from initial intake through resolution.
  • Preferred: Bachelor's degree from an accredited college or university

Responsibilities

  • Assess performance of internal, client or vendor case files or records for accuracy, consistency and compliance.
  • Identify trends and areas of opportunity for increased service efficiency, education and quality.
  • Compile audit results and submit to manager for review.
  • Monitor ongoing action items logs and project plans with appropriate stakeholders.

Key facts

Hard skills

Other skills

  • Analytical Skills
  • Non-Verbal Communication
  • Microsoft Office
  • Program Management
  • Organizational Skills
  • Teamwork

About the company

EFI Global logo

EFI Global

  • Engineering Services
  • SME
  • 501–1,000
Over the last four decades, we have grown from a boutique firm specializing in handling insurance fraud and arson cases and providing expert witness testimony, to becoming a recognized leader in engineering failure analysis, origin and cause investigations, environmental consulting, laboratory testing and specialty consulting. Each member of our multi-disciplinary team of more than 700 professional engineers, fire investigators, architects and scientists was selected for his or her technical proficiency, in-depth industry knowledge and commitment to professional integrity. Together, our diverse backgrounds and collective insights empower clients to make better-informed business decisions. This expertise, coupled with the extensive coverage of more than 62 national offices plus offices in Canada, the United Kingdom and Brazil to provide global work abroad capability, has earned us a reputation for delivering timely responses that consistently meets our clients’ expectations — anytime, anywhere. EFI Global currently provides engineering services in the state of North Carolina by our partner firm, EFI Global of North Carolina, P.C. We also provide engineering services in the states of New York and New Jersey by our partner firm, EFI Global Engineering of New York, P.C. EFI Global is part of the Sedgwick family of companies, a global leader in the independent insurance claims industry.

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Job 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.

All Lines Claims Adjuster - Quality Assurance Specialist

PRIMARY PURPOSE: To assess, promote and confirm data quality and/or performance of investigative service partners and internal resources by performing quality audits of case files or client records to ensure optimal service delivery and compliance. 

 
ESSENTIAL FUNCTIONS and RESPONSIBILITIES 

  • Assesses performance of internal, client or vendor case files or records at regular intervals for accuracy, consistency and compliance with service level expectations and service agreements. 
  • Identifies trends and areas of opportunity for increased service efficiency, education and quality. 
  • Works in partnership with stakeholders to ensure all required and relevant data elements, including but not limited to client demographics, client contacts, 3rd party connections, contract records, and performance guarantees are accurately and consistently captured in the client relationship management system. 
  • Compiles audit results and submits to manager for review. 
  • Provides audit results for quarterly stewardship reports. 
  • Monitors ongoing action items logs and project plans with appropriate stakeholders. 
  • Updates vendor resources to mapping program 

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. 
  • Full adjusting license in one or more provinces  

Experience 

  • Minimum of Four (4) years of investigative experience or equivalent combination of education and experience required. 
  • Minimum 5 years of claims adjusting experience
  • Demonstrated experience handling both personal and commercial lines claims.
  • Strong background in adjusting auto and property claims from initial intake through resolution.

Skills & Knowledge 

  • Oral and written communication skills 
  • PC literate, including Microsoft Office, Excel, PowerPoint products 
  • Analytical and interpretive skills 
  • Strong organizational skills 
  • Ability to work independently or in a team environment 
  • Ability to meet or exceed Performance Competencies 

Job type:

We are currently hiring for this position


Compensation Information:

Salary Range: $47,116.00 - $61,251.00 - $75,386.00 CAD Annual


This position is full-time, and compensation is salaried.

Compensation is determined based on experience, qualifications, and internal equity. Sedgwick is committed to transparent and equitable pay practices.


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. 


Where applicable, Sedgwick uses artificial intelligence tools to assist in the screening, assessment, or selection of candidates. These tools are subject to periodic review.


We are committed to inclusive, barrier-free recruitment and selection processes. If contacted for an employment opportunity, please advise Colleague Resources if you require accommodation. 

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