What are the responsibilities and job description for the Claims Auditor - Workers Compensation (Temporary/Project Based) position at Alan Gray LLC?
Job Description
Job Description
Background
Alan Gray LLC is a leading audit and advisory firm with over 30 years of excellence in providing a range of services to insurance-industry clients. Our goal is to help our clients realize significant bottom-line savings. Our experienced team is committed to staying current with the latest industry information and advances in technology in order to provide excellent service to our clients.
Claims Auditor :
The claim auditor will review and provide comments on workers’ compensation claim files as part of ongoing best practices audits. The auditor will apply his or her experience and training, along with specific account instructions and pertinent regulations, to evaluate all aspects of claim handling, including coverage determinations, negotiations, internal and external communications, and the notation and documentation contained in the files under review.
Please Note - This is an evergreen posting designed to build a pipeline of qualified candidates that we can contact when projects and engagements require additional talent.
Key Objectives :
- Investigate and evaluate workers' compensation claims as part of claim audits.
- Review, analyze and provide opinions as to claim handling practices of claims handled by Third Parties.
- Depending on experience and ability, the position may require project management responsibilities where the individual will direct and oversee audits and manage assigned auditors.
- Review regulatory compliance and proper handling of moderate to complex claims.
- Demonstrate proficiency in claim file management and customer service.
Qualifications :
Education and Experience :