Senior Level Claims Auditor Jobs
Senior level claims auditor jobs place experienced professionals in charge of audit strategy, complex claims investigations, and the cross-functional teams or workflows that deliver accurate, defensible outcomes. Openings are concentrated across Insurance, Technology & Software, and Retail, with a mix of on-site, remote, and hybrid settings, and employers like Liberty Mutual Insurance, Conduent, and Sedgwick hiring at this level now.
Find JobsOverview
Showing 5 of 25+ Senior Level Claims Auditor jobs
INTRODUCTION
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.
Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies
Certified as a Great Place to Work®
Fortune Best Workplaces in Financial Services & Insurance
ROLE AND RESPONSIBILITIES
PRIMARY PURPOSE OF THE ROLE: To analyze complex or technically difficult medical malpractice claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within Company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service.
ARE YOU AN IDEAL CANDIDATE?
We are seeking experienced professionals to manage complex medical malpractice claims involving severe injury and high exposure. Ideal candidates demonstrate strong analytical and negotiation skills, exercise sound judgment, and are committed to delivering timely, cost-effective claim resolutions while maintaining a high level of customer service.
ESSENTIAL RESPONSIBILITIES MAY INCLUDE:
- Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
- Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions.
- Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life.
- Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement.
- Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines.
- Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients.
- Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost.
- Represents Company in depositions, mediations, and trial monitoring as needed.
- Communicates claim activity and processing with the client; maintains professional client relationships.
- Ensures claim files are properly documented and claims coding is correct.
- Refers cases as appropriate to supervisor and management.
- Performs other duties as assigned.
- Supports the organization's quality program(s).
QUALIFICATIONS
Education & Licensing: 6 years of claims management experience or equivalent combination of education and experience required.
- Bachelor's degree from an accredited college or university preferred. Licenses as required.
- Professional certification as applicable to line of business preferred.
Work environment requirements include –
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
COMPENSATION
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 $100,000 to $125,000. 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.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.
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.
INTRODUCTION
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.
Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies
Certified as a Great Place to Work®
Fortune Best Workplaces in Financial Services & Insurance
ROLE AND RESPONSIBILITIES
PRIMARY PURPOSE OF THE ROLE: To analyze complex or technically difficult medical malpractice claims; to provide resolution of highly complex nature and/or severe injury claims; to coordinate case management within Company standards, industry best practices and specific client service requirements; and to manage the total claim costs while providing high levels of customer service.
ARE YOU AN IDEAL CANDIDATE?
We are seeking experienced professionals to manage complex medical malpractice claims involving severe injury and high exposure. Ideal candidates demonstrate strong analytical and negotiation skills, exercise sound judgment, and are committed to delivering timely, cost-effective claim resolutions while maintaining a high level of customer service.
ESSENTIAL RESPONSIBILITIES MAY INCLUDE:
- Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
- Conducts or assigns full investigation and provides report of investigation pertaining to new events, claims and legal actions.
- Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout claim life.
- Recommends settlement strategies; brings structured settlement proposals as necessary to maximize settlement.
- Coordinates legal defense by assigning attorney, coordinating support for investigation, and reviewing attorney invoices; monitors counsel for compliance with client guidelines.
- Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall claim cost for our clients.
- Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost.
- Represents Company in depositions, mediations, and trial monitoring as needed.
- Communicates claim activity and processing with the client; maintains professional client relationships.
- Ensures claim files are properly documented and claims coding is correct.
- Refers cases as appropriate to supervisor and management.
- Performs other duties as assigned.
- Supports the organization's quality program(s).
QUALIFICATIONS
Education & Licensing: 6 years of claims management experience or equivalent combination of education and experience required.
- Bachelor's degree from an accredited college or university preferred. Licenses as required.
- Professional certification as applicable to line of business preferred.
Work environment requirements include –
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
COMPENSATION
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 $100,000 to $125,000. 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.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.
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.
See All 25 Senior Level Claims Auditor Jobs
Find roles that match your experience and apply in just a few clicks.
Find JobsSenior Level Claims Auditor Job Market
Who's Hiring
Top Industries Hiring
- Insurance16
- Technology & Software2
- Retail1
- Airlines1
- Construction & Real Estate1
Senior Level Claims Auditor Jobs: Frequently Asked Questions
How do I get a senior level claims auditor job?
Employers at this level look for candidates who have independently led audits, identified systemic billing or coverage discrepancies, and influenced policy or process improvements as a result. Demonstrating that you have mentored junior auditors, presented findings to leadership, and worked across departments such as legal, compliance, or operations gives you a clear edge over candidates with only technical auditing experience.
Which companies hire senior level claims auditors?
Companies hiring senior level claims auditors right now include Liberty Mutual Insurance, Conduent, and Sedgwick, based on current listings on Migrate Mate as of November 2026. Hiring at this level tends to come from large insurers, managed care organizations, third-party administrators, and healthcare systems that run high-volume or high-complexity claims operations.
Are there remote senior level claims auditor jobs?
Yes, though availability varies by employer and audit function. About 54% of senior level claims auditor openings are remote or hybrid as of November 2026, reflecting broader adoption of distributed audit teams across insurance and healthcare. Roles requiring direct access to sensitive records or vendor sites are more likely to remain on-site.
What makes a claims auditor role senior level?
Senior level claims auditor roles are defined by scope and ownership. Where mid-level auditors execute assigned audits, senior auditors design audit programs, set review criteria, and own the accuracy of conclusions presented to leadership or regulators. They typically guide less experienced staff, resolve escalated or contested findings, and contribute directly to compliance strategy or vendor oversight frameworks.
Which industries hire the most senior level claims auditors?
Senior Level claims auditor roles concentrate in Insurance, Technology & Software, and Retail, based on current listings on Migrate Mate as of November 2026. These sectors drive demand because high claims volume, regulatory scrutiny, and financial exposure at scale make experienced audit oversight essential rather than optional.