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Operational Audit Manager
at NCCI Holdings, Inc. in Florida
At NCCI Holdings, Inc., we realize our greatest asset is our team of more than 900 professionals working together every day to make our company the leading provider of workers compensation insurance data and research information. Read on to learn about the requirements for this opening.
Job Purpose:
Responsible for all aspects of management of the operational audit department, including the management of employees. Ultimately responsible for overseeing and carrying out operational audits (functional audit areas to include underwriting, audit, loss prevention, claims attributes, and internal controls) of servicing carriers of the National Worker’s Compensation Reinsurance Pool, and/or of the several state workers’ compensation reinsurance pools, by determining the servicing carriers’ compliance with applicable guidelines, performance standards, bid enhancements, state laws and regulations, statutory requirements, and best business practices. In charge of ensuring that the Operational Audit objectives are met.
Major Duties:
Manages employees with management duties that include, but are not limited to: making hiring and staffing decisions; writing position descriptions; assessing performance; making pay decisions, disciplinary, and separation decisions; designing and coordinating work schedules, work assignments, and PTO and other leave requests; and directing the day-to-day work of the staff. Also responsible for developing relevant training programs and training and instructing staff on all phases of the operational audit, including the appropriate methodologies, processes, and procedures to be used.
Responsible for planning, managing, overseeing, and communicating all pre-audit duties and functions. Pre-audit duties and functions include but are not limited to determining the parameters of the audit approach; insuring that departmental procedures and appropriate audit techniques, and document requests are accurately prepared and dispatched in a timely manner; reviewing and analyzing (and overseeing the review and analysis of servicing carriers’ documents, to identify any deficiencies in the core functional audit areas prior to commencement of the audit.
Travels to servicing carrier audit site or uses remote audit capability and is responsible for carrying out, managing and overseeing and analyzing carrier data through appropriate testing procedures and methodologies to determine the servicing carriers’ compliance with guidelines, performance standards, bid enhancements, state laws and regulations, and best business practices. Makes decisions to accomplish the purpose of the audit, including the determination of the applicability of, and interpreting, established rules, guidelines, and standards that servicing carriers are required to comply with for each functional audit area being tested, as well as whether any deviation from any established rules, guidelines, and standards is necessary based on facts revealed during the audit. Reviews staff recommendations and/or making recommendations directly to servicing carriers (such as the imposition of fines, implementation of internal controls, and the like) due to non-compliance issues.
Reviews and/or produces timely and accurate audit reports containing such recommendations for carriers review and comments. In charge of communicating recommendations to servicing carriers prior to issuance of the final audit report to allow servicing carriers the opportunity to submit any proposed responses to the recommendations. Evaluates carrier comments and responses to any recommendations to resolve any issues and determine whether there should be any modifications to the audit report. Oversees and/or presents the final audit report by actively participating in and/ or managing the presentation of the audit findings during the exit meeting at audit conclusion.
Develops and maintains working relationships with Servicing Carrier Management and Independent Bureaus to ensure audits are effectively and efficiently performed and completed. Also, provides ongoing contact with Servicing Carriers for follow-up and final resolution of audit issues. Coordinates discussions with other NCCI departments when technical issues and questions arise while conducting an audit of a servicing carrier and require the ability to technically comprehend and analyze the situation with other NCCI departments or other external customers to obtain resolution of issues and questions.
Required Education, Experience & Skills:
Bachelors Degree in Accounting, Business or Insurance
7 years of workers compensation underwriting and /or claims experience. Two years of supervisory or management experience.
Experience with proper audit techniques and methodologies, having the ability to arrive at the desired results with the information provided. Knowledge and expertise in techniques and standards of audit specifically as regards claims and claim adjudication.
Knowledge and expertise in statistical sampling methods. Expertise in testing online applications and databases.
Specialized knowledge of workers compensation resources and concepts such as underwriting manuals (on subjects including policy writing and premium audit rules, experience rating, assigned risk rules, forms and endorsements, claims, and coal mine rating), servicing carrier standards, WCIP plans, statistical plan, classification assignments, state statutes, USL&H/FELA coverage, etc.
Excellent oral and written and analytical skills; along with the ability to effectively write document, as well as the ability to conduct public presentations.
Computer skills, software knowledge and experience in Microsoft Excel, Word, PowerPoint, Access and Windows; and knowledge of database structures.
Proficient in the workers' compensation premium audit process. Knowledge of rating/classification processes.
Specialized knowledge of pertinent state laws and regulations and ability to interpret complex and highly technical rules, guidelines, and standards applicable to residual market workers’ compensation servicing carriers. .
Able to recognize potential problems and communicate effectively with the servicing carrier management/supervisory personnel to ensure the proper resolution. Demonstrated ability to lead a team in the accomplishment of work objectives and results.
Ability to negotiate and resolve issues and conflicts. Effectively perform under pressure, often for extended periods of time. Action oriented; able to negotiate for effective results.
Ability to travel for 1-2 weeks at a time for approximately 20%of the year.
Preferred Education, Experience & Skills:
Knowledge of and expertise in the following NCCI applications: DCA, RPFS, UDAT, RIS, PICS, Risk Workstation, Online Manuals and Circulars, CSS and PUPS.
Knowledge of residual market data reporting requirements.
Related Keywords: Auditor, Reinsurance, Financial Audits, Workers Compensation Audits, Audit Manager, Insurance Auditor
As key contributors to our success, our team members enjoy working in a casual, collaborative environment that offers state-of-the-art resources, advanced technologies, and a superior benefits package.
We require a drug screen and background check.
EEO/Smoke Free environment
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar: http://ncci.contacthr.com/18759252
Job Purpose:
Responsible for all aspects of management of the operational audit department, including the management of employees. Ultimately responsible for overseeing and carrying out operational audits (functional audit areas to include underwriting, audit, loss prevention, claims attributes, and internal controls) of servicing carriers of the National Worker’s Compensation Reinsurance Pool, and/or of the several state workers’ compensation reinsurance pools, by determining the servicing carriers’ compliance with applicable guidelines, performance standards, bid enhancements, state laws and regulations, statutory requirements, and best business practices. In charge of ensuring that the Operational Audit objectives are met.
Major Duties:
Manages employees with management duties that include, but are not limited to: making hiring and staffing decisions; writing position descriptions; assessing performance; making pay decisions, disciplinary, and separation decisions; designing and coordinating work schedules, work assignments, and PTO and other leave requests; and directing the day-to-day work of the staff. Also responsible for developing relevant training programs and training and instructing staff on all phases of the operational audit, including the appropriate methodologies, processes, and procedures to be used.
Responsible for planning, managing, overseeing, and communicating all pre-audit duties and functions. Pre-audit duties and functions include but are not limited to determining the parameters of the audit approach; insuring that departmental procedures and appropriate audit techniques, and document requests are accurately prepared and dispatched in a timely manner; reviewing and analyzing (and overseeing the review and analysis of servicing carriers’ documents, to identify any deficiencies in the core functional audit areas prior to commencement of the audit.
Travels to servicing carrier audit site or uses remote audit capability and is responsible for carrying out, managing and overseeing and analyzing carrier data through appropriate testing procedures and methodologies to determine the servicing carriers’ compliance with guidelines, performance standards, bid enhancements, state laws and regulations, and best business practices. Makes decisions to accomplish the purpose of the audit, including the determination of the applicability of, and interpreting, established rules, guidelines, and standards that servicing carriers are required to comply with for each functional audit area being tested, as well as whether any deviation from any established rules, guidelines, and standards is necessary based on facts revealed during the audit. Reviews staff recommendations and/or making recommendations directly to servicing carriers (such as the imposition of fines, implementation of internal controls, and the like) due to non-compliance issues.
Reviews and/or produces timely and accurate audit reports containing such recommendations for carriers review and comments. In charge of communicating recommendations to servicing carriers prior to issuance of the final audit report to allow servicing carriers the opportunity to submit any proposed responses to the recommendations. Evaluates carrier comments and responses to any recommendations to resolve any issues and determine whether there should be any modifications to the audit report. Oversees and/or presents the final audit report by actively participating in and/ or managing the presentation of the audit findings during the exit meeting at audit conclusion.
Develops and maintains working relationships with Servicing Carrier Management and Independent Bureaus to ensure audits are effectively and efficiently performed and completed. Also, provides ongoing contact with Servicing Carriers for follow-up and final resolution of audit issues. Coordinates discussions with other NCCI departments when technical issues and questions arise while conducting an audit of a servicing carrier and require the ability to technically comprehend and analyze the situation with other NCCI departments or other external customers to obtain resolution of issues and questions.
Required Education, Experience & Skills:
Bachelors Degree in Accounting, Business or Insurance
7 years of workers compensation underwriting and /or claims experience. Two years of supervisory or management experience.
Experience with proper audit techniques and methodologies, having the ability to arrive at the desired results with the information provided. Knowledge and expertise in techniques and standards of audit specifically as regards claims and claim adjudication.
Knowledge and expertise in statistical sampling methods. Expertise in testing online applications and databases.
Specialized knowledge of workers compensation resources and concepts such as underwriting manuals (on subjects including policy writing and premium audit rules, experience rating, assigned risk rules, forms and endorsements, claims, and coal mine rating), servicing carrier standards, WCIP plans, statistical plan, classification assignments, state statutes, USL&H/FELA coverage, etc.
Excellent oral and written and analytical skills; along with the ability to effectively write document, as well as the ability to conduct public presentations.
Computer skills, software knowledge and experience in Microsoft Excel, Word, PowerPoint, Access and Windows; and knowledge of database structures.
Proficient in the workers' compensation premium audit process. Knowledge of rating/classification processes.
Specialized knowledge of pertinent state laws and regulations and ability to interpret complex and highly technical rules, guidelines, and standards applicable to residual market workers’ compensation servicing carriers. .
Able to recognize potential problems and communicate effectively with the servicing carrier management/supervisory personnel to ensure the proper resolution. Demonstrated ability to lead a team in the accomplishment of work objectives and results.
Ability to negotiate and resolve issues and conflicts. Effectively perform under pressure, often for extended periods of time. Action oriented; able to negotiate for effective results.
Ability to travel for 1-2 weeks at a time for approximately 20%of the year.
Preferred Education, Experience & Skills:
Knowledge of and expertise in the following NCCI applications: DCA, RPFS, UDAT, RIS, PICS, Risk Workstation, Online Manuals and Circulars, CSS and PUPS.
Knowledge of residual market data reporting requirements.
Related Keywords: Auditor, Reinsurance, Financial Audits, Workers Compensation Audits, Audit Manager, Insurance Auditor
As key contributors to our success, our team members enjoy working in a casual, collaborative environment that offers state-of-the-art resources, advanced technologies, and a superior benefits package.
We require a drug screen and background check.
EEO/Smoke Free environment
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar: http://ncci.contacthr.com/18759252
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Published on Feb 25, 2011
Viewed: 351 times
Viewed: 351 times
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