NCCI
Insurance Auditor - Workers Compensation
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Job Description
- Req#: 589
- We respect each other and value our differences.
- We can be authentic and feel like we belong.
- We promote equity in our organization and our community.
- Select audit testing samples
- Issue preliminary questionnaires and document requests to servicing carriers
- Review and analyze servicing carrier responses to identify deficiencies in functional audit areas before the audit begins
- Travel to servicing carrier audit sites or use remote audit capabilities
- Apply appropriate testing procedures and methodologies to analyze servicing carrier data
- Evaluate compliance with guidelines, performance standards, bid enhancements, state laws, regulations, and best practices
- Review insured's claim data, systems, and business operations
- Review claim files and data to ensure coding accuracy
- Examine servicing carrier's accounting/financial records and Pool financial reporting systems for accuracy in coding and reporting
- Determine the applicability of and interpret rules, guidelines, and standards that servicing carriers must comply with for each functional audit area
- Assess the need for deviations from established rules, guidelines, and standards
- Prepare formal written reports
- Participate in oral presentations to mid-level and senior management
- Provide recommendations to enhance controls and ensure compliance with performance standards
- Evaluate carrier responses to recommendations and resolve any issues
- Participate in special projects as assigned
- Contribute to the development of the audit approach and scope for operational reviews
- Assist in enhancing audit programs, control questionnaires, and audit techniques
- Handle additional work assignments from the manager, including development-related tasks and special projects
- Bachelor’s degree or equivalent experience
- 4+ years of internal audit, financial/operational audit, or insurance operations experience
- Strong understanding of audit techniques and methodologies to achieve desired results with available information
- Expertise in audit techniques and standards related to claims and claim adjudication
- Exceptional analytical skills to identify and assess the significance of audit issues
- Effective oral and written communication skills for discussing audit issues and recommendations professionally and diplomatically
- Capable of communicating audit issues with both technical personnel and business management
- Proficiency in statistical sampling methods and testing online applications and databases
- Skilled in using Microsoft Excel, Word, PowerPoint, Access, and Windows
- Familiarity with database structures
- Ability to identify potential issues and effectively communicate with servicing carrier management for prompt resolution
- Proficient at meeting strict deadlines and timeframes
- Willingness and ability to travel for 2-3 weeks at a time, accounting for approximately 15% of the year
- In-depth understanding of workers' compensation resources, terminology and concepts, including insurance policy components, claims handling, etc.
- Familiarity with insurance data reporting requirements
- Premium audit and classification knowledge
- Ability to interpret complex and highly technical rules, guidelines, and standards related to residual market workers’ compensation servicing carriers
- Knowledge of pertinent state laws and regulations
- Certified Internal Auditor (CIA) or Certified Information Systems Auditor (CISA) certification would be an advantage
- Work for the leader in workers compensation information providing data, insights, and tools for almost 1,000 insurance companies
- Competitive starting base pay plus a targeted annual performance bonus
- Phenomenal work environment, with perks including an onsite café, coffee shop, game room, fitness center, and employee activities and sports leagues to participate in
- Wonderful team of dynamic people to work with who are fun, caring, and friendly
- Positive work environment and culture that celebrates success and honors each other’s contributions to the team
- Fantastic benefits package and total rewards offerings
WHO WE ARE:
Since 1923, NCCI has been committed to fostering a healthy workers compensation system. We are the nation’s trusted source for accurate, objective workers compensation information. At NCCI, we recognize that our employees are the reason our legacy endures today. We’re motivated by the opportunity to do challenging and interesting work, and our Total Rewards package attracts top talent. Our employees care about each other, and the communities in which they live and work. Our values of integrity, respect, quality and excellence, responsibility, and commitment guide our success.
WHAT WE BELIEVE:
We come from diverse backgrounds, so our commitment to inclusion is what brings us together to work as one.
At NCCI, we’re looking for an Insurance Auditor to join our team! You'll play a pivotal role in safeguarding the integrity of the National Workers Compensation Reinsurance Pool and state workers compensation reinsurance pools.
In this role, you'll conduct comprehensive audits across key functional areas, including underwriting, audit, loss prevention, claims financial reporting, collections, and more. Your mission will be to ensure that our servicing carriers meet not only financial reporting standards but also the highest levels of compliance with operating guidelines, performance standards, state laws, and industry best practices.
If you are a detail-oriented professional with a passion for ensuring financial integrity and adherence to industry standards, this role may be for you!
This position will work in a flexible-hybrid environment. The selected candidate must be within a commutable distance to our Boca Raton, FL headquarters.
NOTE: NCCI will not sponsor applicants for work visas.
WHAT YOU’LL DO:
Pre-Audit Preparation
Audit Process
Interpretation of Rules and Guidelines
Reporting and Communication
Special Projects and Development
Managerial Assignments
WHAT IT TAKES:
Education and Experience:
Audit Proficiency
Analytical Skills
Communication Skills
Technical Abilities
Problem Solving
Time Management
Travel Flexibility
PREFERRED SKILLS & EXPERIENCE:
Insurance and Workers Compensation Knowledge
Regulatory Comprehension
Certification (Optional)
WHAT YOU’LL RECEIVE:
WHO TO CONTACT:
Zach Wierzba
Sr Talent Acquisition Specialist
EQUAL EMPLOYMENT OPPORTUNITY:
NCCI Holdings, Inc. is an Equal Opportunity Employer. It is our policy to provide equal opportunities to our employees (for example, in hiring, promotions, training) and to all job applicants, and to maintain a work environment free of discrimination on the basis of race, creed, color, national origin, marital and veteran status, gender, age, status as a qualified individual with a disability, religion, sexual orientation and gender identity or expression, genetic information, or any other basis prohibited by law. This policy applies to all employees and job applicants for employment.
We require a drug screen and background check. Smoke Free environment.
About the company
The National Council on Compensation Insurance is the nation's most experienced provider of workers compensation information, tools, and services.
Notice
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