Claims Validator - Investigation Services - Sedgwick Claims Management Services, Inc.

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.

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Claims Validator - Investigation Services

Home Investigations is an integral part of Sedgwick, providing our internal and external clients with a robust counter fraud response. We do not adopt a one size fits all approach but deliver a cost-effective defence against fraud. Our work requires skilled and talented individuals to assess certain claims that are potentially fraudulent, so the work is never dull.  Continued growth gives us the opportunity to welcome new talent to our team.

The role of the Claims Validator involves handling claims for a key client on a delegated authority basis through the use of conversation management via both video & telephone, so you’ll need to be a confident communicator and comfortable with technology.

Handling both domestic & commercial claims identified as potentially suspect following initial client led triage, you’ll manage your caseload carrying out necessary investigations, enquiries and validation activities. Pro-activity is key - maintaining constant contact with our policyholders and taking accurate information and records, mindful of the customer journey and need for accuracy.

You’ll engage with stakeholders including commodity suppliers to help validate claims and also undertake enquiries with the police where necessary, to enable you to complete swift settlement enquiries through negotiation and the use of the Insurer supply chain network.

The role also involves;

• Keeping abreast of current legislation and codes of practice as they relate to insurance investigations
• Issuing repudiation & fraud outcome letters to customers
• Dealing with complaints and seek to resolve within the FCA guidelines
• Identifying, managing and evidencing fraud through the use of data, technology and a strong investigative mindset.
• Reporting and evidencing fraudulent activity to the IFB, IFIG & IFED

If you’re passionate about combatting fraud, adaptable, enjoy delivering superb service and are looking for a role which supports creative thinking where we’ll invest in your on-going development with the opportunity to work from home, we’d love to hear from you!

You will have/will be:

• Claims handling experience or wider insurance industry experience
• A working knowledge of industry standards and detection benchmarks
• Some technical knowledge of home and/or commercial insurance policies and documentation
• Some experience of investigating fraudulent claims and/or experience in handling a portfolio of general domestic/commercial claims with an interest in fraud
• Ideally Cert CILA or Cert CII qualified
• An understanding of the role of the IFB, IFIG & IFED & the ability to refer cases that hit the evidential threshold would be beneficial
• Prior conversation management experience is desirable

What will you get for this role?

• Competitive salary depending on skills, experience and qualifications
• Healthcare scheme
• A Self Invested Personal Pension Scheme
• Holiday allowance of 25 days plus bank holidays
• Discounts on various products and services
• Employee assistance programme for employee wellbeing
• Life assurance
• Group Income Protection
• Voluntary benefits – dental cover, cycle to work scheme, season ticket loan, wellbeing and digital GP apps
• Flexible working

Working at Sedgwick

Our company is a place where creative and caring people of all backgrounds can be challenged, grow as individuals, and feel a higher purpose in the unique value they bring and the difference they make in the lives of others. We celebrate our differences; cultivating uniqueness and belonging allows us to connect with our consumers on a personal level, understand our clients’ needs, support the communities in which we operate, and perform at our best.

We’re passionate and understanding about our colleagues – so we have built flexibility into our colleague working model. If you wish to work from home, split your working time between the home and office or change your hours so you can collect your children or care for someone in your family, we’re supportive of that. As a flexible employer, we’re happy to discuss options that take into consideration your personal needs for this position during your interview.

Applicants who are successful at interview will be, as part of pre-employment screening, subject to: ID document verification, credit check, address verification, employment verification, employment gap verification, UK DBS, UK financial regulator search, anti-money laundering search, directorship search and global watch list check.

Sedgwick is committed to Equal Opportunity and Diversity. We aim to ensure that no job applicant or employee receives less favourable treatment on the ground of race, colour, nationality, religion, ethnic or national origins, age, gender, marital status, sexual orientation or disability.

#LI-REMOTE

Sedgwick is an Equal Opportunity Employer.

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. Sedgwick retains the discretion to add or to change the duties of the position at any time.