Auto Claims Auditor

Job Description

Job Description

We are seeking an analytical and detailed-orientated professional with vast experience in personal and commercial automobile insurance claim audits and / or similar property and casualty internal audits roles.

This role will initially be responsible for managing and conducting claim audits for adherence with both regulatory compliance and other departmental best practices as well as evaluating departmental controls to provide recommendations for streamlining procedures and enhancing risk management.

This role is an exceptional opportunity to be a part of an expanding insurance company in a dynamic and collaborative environment.

This is a full-time position reporting to the Director of Compliance and may allow for a combination of in-office and work-from-home location for the right candidate.

Duties & Responsibilities

• Conducts comprehensive and follow up Focused Department Reviews of assigned insurance claims and report findings to the impacted Focused Department to ensure the accuracy of the following :
• File documentation
• Compliance with internal policies, statutory regulations, and industry best practices
• Timely and consistent customer service levels & claims decisions provided
• Risk mitigation
• Adherence to business units' guidelines and operating policies & procedures
• Alignment with industry and company best practices
• Finalize and provide the initial report and action plan recommendations to the impacted business unit's leadership and monitor for final action plan from impacted business unit.
• Facilitate meetings with the impacted business unit's leadership team, senior management and Claims Training & Systems Development unit to present final report and impacted business unit's action plan.
• Provide proper follow-up and oversight of the execution and completion of the business unit's finalized action plan.
• Develop Legal / Compliance's departmental guidelines to assist other business unit's alignment with internal policies, statutory regulations, and industry best practices and update as needed to comply with other impacting regulatory or operational changes.
• Supports Claims Training & Systems Development unit and other business units training needs in conjunction with overall regulatory compliance as needed.
• Perform additional duties as assigned by the General Counsel or Director of Compliance.

Qualifications Required

• Bachelor's Degree or 6+ years of personal and commercial automobile insurance claims auditing and / or similar property and casualty work experience.
• Profound technical knowledge of insurance industry and auditing of personal and commercial auto insurance with a focus on claims handling, internal policies, statutory regulations, and industry best practices.
• Robust detailed-oriented and critical thinking skills needed to interpret and communicate complex problems and solutions effectively with all levels of our organization.
• Able to utilize and manage all available resources to make informed decisions and achieve superior results.
• Seeks out to understand other business units' needs, long term goals, objectives and challenges in order to formulate recommended solutions and guidance.
• Possess strong self-management & organizational skills in order to prioritize multiple deadline-driven assignments, with ability to shift focus as needed.
• Excellent time management, written and verbal communication skills with a high level of professionalism, and attention to detail.
• Self-motivated with the ability to work independently.
• Knowledge of the following is preferred, but not required :
• Microsoft Office Suite, including OneNote and Lists.
• Viewing records in Guidewire, PTS, and ImageRight.
• Thomson Reuters' Westlaw and APCIA Compliance research resources.

Job Posted by ApplicantPro