High School Diploma or equivalent required; Bachelor's degree in business administration, finance, or insurance-related field is a plus., 3-5 years of customer service experience; 1-3 years of current Workers' Comp Premium Audit experience required., Basic knowledge of accounting principles and financial documents beneficial; understanding of PCRB regulations and familiarity with NCCI regulations is preferred., Strong verbal and written communication skills, with the ability to manage multiple tasks and prioritize effectively..
Key responsabilities:
Manage the audit staff and coordinate operations related to Workers Compensation premium audits.
Establish and review performance goals for the team, addressing any issues that impact service delivery.
Maintain strong working relationships with internal and external customers, assisting in resolving high visibility problems.
Monitor team performance against targets and facilitate training initiatives within the Premium Audit Team.
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A $23 billion health care provider and insurer, Pittsburgh-based UPMC is inventing new models of patient-centered, cost-effective, accountable care. The largest nongovernmental employer in Pennsylvania, UPMC integrates 92,000 employees, 40 hospitals, 700 doctors’ offices and outpatient sites, and a 4 million-member Insurance Services Division, the largest medical insurer in western Pennsylvania. In the most recent fiscal year, UPMC contributed $1.4 billion in benefits to its communities, including more care to the region’s most vulnerable citizens than any other health care institution, and paid more than $800 million in federal, state, and local taxes. Working in close collaboration with the University of Pittsburgh Schools of the Health Sciences, UPMC shares its clinical, managerial, and technological skills worldwide through its innovation and commercialization arm, UPMC Enterprises, and through UPMC International. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside among the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals. For more information, go to UPMC.com.
UPMC Health Plan is hiring a full-time Supervisor, WC Premium Audit to support the Workers Comp Underwriting team. This role will predominantly work remotely and may reside anywhere within the continental US. Employee will be expected to work standard daylight hours EST.
This role reports to the Underwriting Support Manager. The individual will manage the audit staff and manages and coordinates operations as it relates to Workers Compensation premium audits.
Responsibilities:
Manages the work activities and has full management accountability for the performance and development of reporting staff in accordance with departments strategic direction.
Establishes and reviews performance goals including stretch goals and communicates progress, addressing issues that impact service provided by the team members.
Through collaboration with others, establishes and maintains strong working relationships with internal and external customers and assists subordinates in resolving high visibility problem cases or issues.
Acts with a sense of urgency and takes accountability for resolving issues.
Identifies process improvements within the Premium Audit Team as necessary to achieve the best customer experience possible.
Manages and monitors team performance against established targets.
Responsible for staying up to date on trends and developments within functional area of expertise as well as the insurance industry.
Responsible for facilitation and coordination of training initiatives within Premium Audit Team as necessary.
Responsible for monitoring and coordination of premium audit completion by Premium Audit Team and assuring timely receipt of audits from the audit vendor. This includes audit disputes sent to the audit vendor.
Respond to escalated audit specific questions including risk classification, class code application, state rules and other audit related inquiries from policyholders, brokers, and internal staff
Provides status updates and reports out to management as necessary.
Monitors status and assists with all audit final disputes including communication to shareholders as necessary
Audit vendor management – Manage vendor quality through audit reviews, manage time service expectations, manage parent notes with vendor, review vendor invoices, and other premium audit tasks as needed.
Manage state test audit program including, but not limited to, submitting files for test audit selections, submitting and managing rebuttal process for differences, regularly report out on status of test audit results
Additional tasks related to the premium audit function
High School Diploma (or equivalent)
3-5 years of customer service experience (any industry)
1-3 years of current Workers' Comp Premium Audit experience required.
Bachelors degree in business administration, finance, or insurance related field of study is a bonus but not required,
Basic knowledge of accounting principles and financial documents beneficial
Understanding of PCRB regulations
Familiarity with NCCI and individual state rating bureau regulations
Ability to cultivate and maintain a strong relationship with policyholders, brokers, and internal staff
Effective and professional verbal and written communication skills
Customer service driven. Ability to handle multiple tasks and prioritize work. Strong judgement, critical thinking, and decision-making skills.
Solid organizational skills including time management, prioritization, and attention to detail. Knowledge of administrative procedures..
Experience with audit software applications as well as Microsoft Word and Excel
Licensure, Certifications, and Clearances:
Act 34
UPMC is an Equal Opportunity Employer/Disability/Veteran
Annual
Required profile
Experience
Spoken language(s):
English
Check out the description to know which languages are mandatory.