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Premium Audit Reviewer- Workers' Compensation

2 months ago

Lewisville, United States Method Workers Compensation LLC Full time
Job DescriptionJob DescriptionDescription:

Who We Are

Method Workers’ Compensation is a portfolio of workers’ comp companies with the same mission: minimizing the human and financial cost of workplace injuries. We mitigate workplace injuries and deliver exceptional healthcare outcomes for injured workers, expediting a return to work, preserving families’ livelihoods, and enhancing employers’ productivity. We maintain in-house expertise in claims management, medical bill review, underwriting, and loss prevention for high-hazard, high-mod, and mid-market risks. From submission to claim, we’re there every step of the way, improving outcomes for everyone involved. Method currently operates in all states.


What To Expect

As part of the Insurance Services team, the primary responsibility of the Premium Audit Reviewer is to perform a thorough review of Workers Compensation insurance premium audits. Your strong judgment and critical thinking skills will be essential as you examine the completed audit for accuracy and ensure appropriate classifications, exposures, and premium in accordance with company, industry, government rules, regulations and customer specifications are adhered to. You will investigate all discrepancies/variances while effectively communicating with the auditor. You will also work to develop auditor quality by providing technical guidance. This position is a great opportunity to develop and be part of a rapidly growing company. This is a full-time, salaried exempt position with standard business hours of Monday through Friday from 8:00am to 5:00pm, with some flexibility at manager’s discretion.


What You’ll Do

  • Review audits received from vendors / internal auditors by examining audit worksheets, policies, endorsements, and inspections to verify if audit is correct, make corrections or coach where needed.
  • Return the audit to the vendor / internal auditors for corrections only when necessary.
  • Independently determine if each audit adequately addresses the QC requirements, standard manual rules, state-specific rules, and client-specific requirements.
  • Analyzes existing data, policy and audit documentation, industry and statutory materials and claims and enter relevant items into Premium Audit system.
  • Accurate execution and understanding of basic math calculations with attention to detail.
  • Finalizes accurate audit statement that complies with company and bureau regulations. Self-check work to ensure accuracy
  • Validate time charges for vendors with audit detail and/or explanations.
  • Process audit within the Visual Audit system, to create audit statement.
  • Manage inventory of audits to review, meet production requirements and expectations as provided.
  • Assist the audit department administrator with any customer service-related tasks as needed.
  • Remain informed of changes and current information relative to premium auditing through discussion and correspondence with experts and industry-related literature.
  • Handle and/or coordinate disputes as assigned.
  • Perform other duties as assigned by Management.


Requirements:

What You Need

  • A minimum of 5 years workers compensation premium audit review experience
  • Ability to read, analyze and interpret financial reports and tax documents.
  • Must have extensive knowledge of California Rules, regulations, and audit requirements.
  • Must have extensive knowledge of Workers Compensation manual rules: Basic Manual, Scope Manual, State-Specific Manuals for independent bureau states,
  • Must have excellent interpersonal and written/ oral communication skills.
  • Highly motivated and detail-oriented with strong analytical skills
  • Strong problem solving, reasoning, and decision-making skills.
  • Stay abreast of current regulations by reading and maintaining any technical documentation/correspondence. Be self-driven to research, learn, and apply those learnings.
  • Excellent computer skills (Microsoft Applications such as Excel, Word, and Outlook); experience with Visual Audit is helpful.
  • Strong work ethic and commitment to excellence
  • Participating as a team player by providing positive and constructive feedback, sharing information with the team
  • Ability to make independent decisions regarding class codes and exposures with minimal guidance.
  • Work well in a fast-paced, high-volume environment.
  • Flexible and able to reprioritize daily work to align with the needs of the company.
  • High School Diploma or Equivalent


Preferred Experience

  • Premium audit experience, preferably in workers’ compensation.
  • An associate or a bachelor's degree in accounting, finance, or a related field.
  • APA is a plus.


What We Offer:

In exchange for your time and expertise, we offer competitive compensation, 401(k) plus matching, health benefits (including HSA Contribution), paid disability, paid parental leave, professional development opportunities, and a hybrid/remote work environment. This is an opportunity to play a key role in the continued success of a growing organization.

Unless fully remote, this position operates in a professional office setting and routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines. This is largely a sedentary role with prolonged periods of sitting at a desk and working on a computer. However, some filing is necessary and may require the ability to lift files, open filing cabinets and bend or stand on a stool as necessary.

Method Workers’ Compensation is an equal opportunity employer regardless of race, color, gender, age, sexual orientation, gender identity, gender expression, religious beliefs, marital status, genetic information, national origin, disability, protected veteran status, or any other basis protected by federal, state, or local law.