Medical Claims Auditor - Remote Position!

CopperPoint has an exciting opportunity for a Premium Field Auditor II. role, you will conduct medium- to large-complexity physical and virtual Workers’ Compensation and General Liability audits across several states, primarily in rules, as well as Inland Marine and Garage Liability coverages, while working directly with policyholders to complete original and disputed final audits. Premium Field Auditor II ensures all audit information is accurate, compliant with state regulatory requirements, and aligned with company policies and industry standards while delivering exceptional customer service and maintaining Independently conduct final audit of the business operations of the Conduct physical inspection of all operative hazards active for former Verify all Workers’ Compensation claims as valid and are classified correctly for unit statistical purposes. * Analyze business operations to ensure compliance to all regulatory agencies Provide guidance and education to the policyholders regarding monthly payroll reporting as well as the entire final audit process. * Responsible for scheduling premium audits, inventory management of work, resolving audit questions and disputes. * Effectively communicate all necessary policy changes resulting from the final audit to all internal and external customers. * Review all audit disputes with policyholder timely. * Responsible for training and mentoring junior Premium Audit team members. * through undergraduate level studies especially in the areas as business administration, finance or accounting * 5-9 years Audit experience with at least 4-6 years performing field/physical/on-site audits * Intermediate Excel skills a must and experience working with large amounts of payroll data * Excellent Customer Engagement/Service Skills * Has knowledge of a variety of policy types, including guaranteed costs, high deductible, loss retro-incurred, composite rating and group captives * Experience with Microsoft Suite, including Excel, Word and PowerPoint * Experience with secure file transfer platforms and handling of PII data * Superior knowledge of independent bureau and NCCI Worker’s Compensation and General Liability rules, regulations, and test audit states. * Bureaus Rules and State regulations. * Expert knowledge of state insurance regulatory requirements to ensure the Expert knowledge of the various regulatory agencies’ rules pertaining to Insurance Companies benefit plans including medical, dental, vision, short-term disability, long-term disability, life insurance, a health savings account, a flexible spending account, and a 401k plan. * We provide some benefits at no cost to the employee (Basic Life Insurance and AD&D at two times an employee’s annual salary, Short- and Long-term Disability coverage, and Employee Assistant Plan). * Employees will accrue 0.0846 hours of Paid Time Off (PTO) per paid hour, paid holidays throughout the calendar year.

bonus.

Founded in 1925, CopperPoint Insurance Companies is a leading provider of workers’ compensation and commercial insurance solutions. of insurance products and a growing ten-state footprint in the western United CopperPoint Mutual Insurance Holding Company is the corporate parent of Arizona-based CopperPoint Insurance Companies, Alaska National Insurance Company, and other CopperPoint Insurance Entities.

CopperPoint’s culture of compassion extends to the community through employee volunteerism, corporate matching, Board service, program sponsorships, and volunteer time annually and matching their personal contributions to the charities of their choice up to $500 per year. package including major medical, dental, and vision and a wide range of plan, generous paid time off, tuition reimbursement, and other education benefits and business casual dress. without regard to race, color, sex, religion, age, national origin, disability, veteran status, sexual orientation, gender identity or expression, marital or any other characteristic protected by state, federal or local law. LI-Remote