Conduct detailed audits of high-complexity claims files to ensure compliance, accuracy, and adherence to company procedures and regulatory requirements.
Perform in-depth claims file reviews for accuracy and compliance.
Document findings and provide recommendations for corrective action.
Identify trends and collaborate with departments to improve claim practices.
Support audit reporting and analytics.
Requirements
Bachelor's degree preferred; CPCU, AIC, or other insurance certifications a plus.
4
6 years of claims or audit experience.
Strong understanding of claims handling and insurance regulations.
Analytical, organized, and skilled in Excel/audit systems.