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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:
Conducts operational audits (functional audit areas to include underwriting, audit, loss prevention, claims attributes and internal controls) of servicing carriers of the National Workers’ Compensation Reinsurance Pool, and/or several state workers’ compensation reinsurance pools, by determining the servicing carriers’ compliance, with applicable guidelines, performance standards, bid enhancements, state laws and regulations and best business practices.

Major Job Duties:
Performs pre-audit preparation which includes carrying out audit testing selections, preparing and issuing preliminary questionnaires, and document requests to servicing carriers; reviewing and analyzing servicing carrier responses to questionnaires and servicing carrier 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 to analyze servicing 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. Analyzes the insured’s claims data and systems, and business operations; claim files and data to determine accuracy of coding. Determines the applicability of and interprets 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.
Prepares and reviews formal written reports and participates in oral presentations addressed to mid-level and senior management regarding recommendations to improve controls and ensure compliance with performance standards.
Provides assistance in the oversight of audit procedures, development of the audit approach and the determination of the audit scope for operational performance reviews, including the development and enhancement of the audit programs, internal control questionnaires and computerized audit techniques.
Responsible for other work assignments that the manager may assign from time to time, including, but not limited to, development related assignments and special projects.

Required Education, Experience & Skills:
Bachelor's Degree in Accounting, Business or Insurance.
5 years financial/operational audit experience. The 5 years of auditing experience should include IT and/or systems auditing experience and/or workers compensation claims handling.
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 and testing online applications and databases.
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 statues, USL&H/FELA coverage, etc.
Excellent oral, 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.
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.
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, CSS and PUPS.
Knowledge of residual market date reporting requirements.

Related Keywords: Auditor, Reinsurance, Financial Audits

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/19342941

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Published on Apr 14, 2011
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