Demo

Senior Premium Reviewer & Analyst Remote

BCBS of Michigan Group
Detroit, MI Remote Other
POSTED ON 4/19/2025
AVAILABLE BEFORE 6/19/2025

The Senior Premium Reviewer & Analyst plays a critical role in accurately determining earned premium for policyholders. This position involves reviewing and billing all physical audits within five days of receipt. Once audits are finalized, the Analyst will collaborate with various departments and policyholders to address any outstanding issues, policy discrepancies, disputed audits, and regulatory requirements. Additionally, this role will engage with Underwriting supervisors, Accounts Receivable, and other stakeholders to streamline processes and develop procedures aimed at enhancing the accuracy and timeliness of Premium Services operations. The Analyst will support the Manager in overseeing workflow, generating informational reports, and resolving more complex issues within the Premium Services function.

  • Prepares audit orders and voluntary audit requests, paying close attention to special instructions from Underwriting, territory issues, and audit vendor issues.
  • Processes audits as audit work papers are received from auditors/audit vendors (or clients if they are voluntary audits) which includes: verifying various pieces of information on the policy, entering the updated payroll information and re-rating the policy, investigating and analyzing significant variances or other related questionable items, documenting and advising Underwriting of the results of the investigation and analysis.
  • The reviewer must also check for accuracy for a variety of components including arithmetic, respective rating bureaus rules and regulations, classification footnotes, policy endorsements, officer inclusion/exclusion, etc.
  • After the review is completed, he/she will calculate the earned premium and generate an invoice, and forward to the appropriate recipients. This process also includes obtaining required management approvals depending on audit results, as well as providing required billing information to Accounting.
  • Coordinates with Underwriting, the auditor, the associated agent, and, if necessary, Management to resolve audit disputes in a manner that is understood by all parties and approved by Underwriting and/or Management.
  • The reviewer must also follow up with others such as underwriting, collections, claims, respective rating bureaus, and brokers to address open issues on expired and current policies. This correspondence occurs through letter writing, telephone calls, e-mail.
  • The senior reviewer will also work directly with Underwriting, A/R and claims to develop procedures, review open issues and resolve problems that occur in the course of auditing. The senior reviewer will work closely with the director to develop best practices in the Premium Services function. This will include drafting procedures, developing tracking reports, managing data and reporting information to upper management.
  • Calculates dividend payments and coordinates ordering of checks and mailing with Accounting. Handles questions or disputes that arise out of this process, involving Management when necessary.
  • The senior reviewer will assist reviewer with audit assignment and inventory management.
  • Develops and maintains strong working relationships and excellent communication with internal departments (Accounting, Underwriting, etc.) as well as external customers (clients and agents).
  • Assist in training and providing guidance to less experienced Premium Audit Reviewers.
  • Keeps abreast of state and NCCI rules and regulations.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

QUALIFICATIONS

  • Bachelor’s degree in Business Administration or equivalent combination of related coursework and experience is required. Combinations of relevant education and experience may be considered in lieu of a degree. Continuous learning, as defined by the Company’s learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.
  • Five plus years reviewing experience in Workers’ Compensation field audit processing or equivalent combination of relevant coursework and experience required.
  • Working knowledge of Workers’ Compensation classification system and general premium audit procedures are essential. Accounting background preferred.
  • Strong Microsoft Office Suite skills are required.
  • Strong analytical, problem solving and attention to detail skills required.
  • Ability to handle multiple priorities and meet necessary deadlines.
  • Excellent oral and written communication skills and human relations skills required.
  • Ability to work effectively independently and as part of a team.

WORKING CONDITIONS:

Work is performed remotely in a virtual office setting with no unusual hazards.

The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.

Pay Range - Actual compensation decision relies on the consideration of internal equity, candidate’s skills and professional experience, geographic location, market, and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $55,300and $92,600 (P2A).

We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.

#LI-TM1

#AFG

Salary : $55,300 - $92,600

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