Silver Spring, MD
Full-Time Regular
2019260

Location: REMOTE

The Premium Auditor will perform premium audit functions and provide customer service by acting as liaison between the Fund/TPA/Broker/Consultant and the company and serve as the point of contact for:

  1. Fund issues/concerns; follow up with resolutions in a timely manner;
  2. Assist new clients with questions regarding all phases of group insurance administration as well as details of the policy;
  3. Assist the Underwriting Department with obtaining census information and questions regarding membership counts/concerns;
  4. Accompany Sales/Account Executives/Underwriters and other personnel to clients when necessary;
  5. Follow up site visits/conference calls with Fund/Broker/TPA/consultant;
  6. Perform service calls to rectify numerous situations as they develop.

DUTIES:

  • Logistically plan & schedule audits throughout the US areas that include the DC area, mid-Atlantic, mid-west, & South.
  • Perform electronic and/or on-site premium and eligibility audits at self-administered Policy Holders and third party administrators of policies of all types
  • Review policies prior to the audit to discover any misunderstanding or misinterpretation by Fund/TPA/Broker/Consultant/Home Office
  • Obtain, review and analyze necessary data at the audit site to compile Earned vs. Paid Premium/Fee Analysis and lives verification for Aggregate Stop Loss groups
  • Verify claims paid in accordance with Office of Foreign Assets Control (OFAC) and Child Support Lien Network (CSLN) regulations
  • Assist Premium Billing Department with collection and adjustments of premium to ensure prompt collection and follow up, as well as obtaining Lives by Location information for Premium Billing
  • Protect all data received from Fund, TPA or the Company in accordance with Company’s HIPAA policy
  • Assist in maintaining accurate and complete database for reporting audit results

MINIMUM QUALIFICATIONS:

  • Must be located in MID-WEST USA, 1 hour travel time to an airport
  • Bachelor’s Degree in Accounting, Finance or related field
  • One+ years of auditing experience
  • Must be able to travel 60% but varies throughout the year
  • Excellent written and oral communication skills and attention to detail are critical for this role
  • Proficiency in the Microsoft Office suite including Word and Excel