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Are you ready to be a part of a high-performance team of Premium Auditors? If so, we want you to join our award-winning workers’ compensation insurance company in sunny Walnut Creek, California.
The Senior Premium Auditor is an experienced premium auditor responsible for reviewing and performing premium audits, representing Preferred Employers with customers to insure a high quality premium audit experience and acting as a liaison between insureds and company departments. The SeniorPremium Auditor will travel 2 -3 days per week on average, with the possibility of overnight travel, to meet with policyholders in their business locations. In addition, the Senior Premium Auditor will answer policyholder questions, resolve audit disputes, assist with the management of fee audit vendors, train employees and perform any other general duties or projects as assigned and deemed necessary. The Senior Premium Auditor must have excellent analytical and communication skills as well as be a team player committed to customer service and continuous improvement.
- Review, bill and conduct premium audits in accordance with company and state audit guidelines insuring that the proper payroll and classifications are used for determination of premium.
- Perform field audits as assigned
- Maintain working knowledge of the California Workers’ Compensation Uniform Statistical Reporting Plan and NCCI rules.
- Resolve audit disputes.
- Communicate with brokers as necessary with regards to final audit findings.
- Notify other departments of any potential issues discovered at final audit.
- Work with senior staff to improve efficiency of audit department and enhance the customer experience.
- Act as a team leader.
- Assist with training new employees on industry, company, WCIRB and NCCI audit guidelines.
- Assist with management of fee audit vendors.
- Other duties as assigned and deemed necessary.
Join our team of highly skilled Claims Examiners responsible for the analysis and management of workers’ compensation claims. Our Claims Examiners review, investigate, and make decisions regarding coverage, compensability, and appropriateness of claims; as well as process and document claims to ensure compliance with company standards, industry best practices, and legislative provisions. In this position you will act in a fiduciary role on behalf of policyholders, negotiate claim settlements and manage subrogation.
Our Claims Examiners conduct the handling of claims in the utmost of good faith in compliance with the rules, regulations and statutes of the WCAB and State of California. We function with a high degree of competency and sound judgment, coupled with consistent results!
Responsibilities for this opportunity include:
- Analyzing and processing workers’ compensation claims by investigating and gathering information to determine the exposure on the claim.
- Negotiating the settlement of claims up to designated authority level and making claims payments.
- Calculating and assigning timely and appropriate reserves to claims and continuing to manage reserve adequacy throughout the life of the claim.
- Calculating and paying benefits due; approving all claim payments; and settling claims within designated authority level.
- Developing and managing claims through well-developed action plans; continuing to work the action plan to bring the claim to an appropriate and timely resolution.
- Preparing necessary state filings within statutory limits.
- Actively managing the litigation process; ensuring timely and cost effective claims resolution.
- Coordinating vendor referrals for additional investigation and/or litigation management.
- Using appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims.
- Managing claim recoveries of all types, including but not limited to subrogation, Second Injury Fund recoveries, and Social Security offsets.
- Reporting claims to the excess carrier, responds to requests of directions in a professional and timely manner.
- Frequently communicating with all appropriate parties involved with the claim.
- Referring cases as appropriate to management.
- Maintaining professional client relationships.
- Actively executing appropriate claims activities to ensure consistent delivery of quality claims service.
The Premium Audit Intern is responsible for administrative functions within the premium audit department and will gain knowledge of the insurance industry and premium audit function at a workers’ compensation insurance carrier. The PremiumAudit Intern will assist the premium audit department by providing administrative support. Responsibilities to include data entry work, processing incoming/outgoing mail, billing final audits per department guidelines, assisting in-house premium auditors and fee audit vendors as needed, running reports to ensure proper field audit assignments, preparing payroll audit worksheets and other general duties as assigned and deemed necessary.
- Process incoming/outgoing mail including data entry
- Send letters of engagement and assist in-house and fee audit vendors when
- Run and analyze reports to ensure all subject policies are properly field
- Bill final audits per guidelines.
- Prepare payroll audit worksheets.
- Assist premium audit analysts by providing administrative
The Claims Supervisor directly reports to the Manager of the Claims Department and is an integral member of the Claims Leadership Team. The Claims Supervisor is responsible for the analysis and management of claim files within their unit. Supervision includes: claim assignments, coverage analysis, establishment of and adherence to action plans in claim files, reserve accuracy, effective negotiation and appropriate resolution. The Claims Supervisor is a mentor to not only the specific unit, but also the entire claims department and is available for consultation/discussion with staff as the primary responsibility. The Claims Supervisor is responsible for staff training and development. The Claims Supervisor will work closely with other members of Claims Leadership to insure the efficient and effective resolution of issues. The Claims Supervisor is charged with managing pending claims, improving file quality and controlling expenses. The Claims Supervisor will conduct the management of claims in the utmost of good faith in compliance with the rules, regulations and statutes of the WCAB and State of California. The Claims Supervisor is expected to function at a high level of expertise and competency, while consistently exercising good judgment and independent discretion. The Claims Supervisor is expected to support Company goals, Department Goals and advance Company values.
- Direct management of staff of up to 6 examiners and their claim files
- Manage Loss Costs
- Manage Loss Expenses
- Analyzes file plans
- Approve action plans in accordance with best practices
- Complete 10-day diary reviews on all new losses and maintain active diaries of all claims in the unit
- Document the claim file of all activities taken
- Work with the examiner throughout the life of the claim
- Use appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims
- Frequently communicate with all appropriate parties involved with the claim
- Maintain professional vendor relationships
- Actively execute appropriate claims activities to ensure consistent delivery of quality claims service
- Recommend staff payment and settlement authority for employees in unit
- Compliance with state laws and regulations regarding claim handling
- Shared responsibility for department budget, which includes planning and ongoing management of salary and expenses
- Claim Management as measured through aggressive action plans and overall supervision as measured by reduction in average paid and average age of cases at time of closing
- Other tasks assigned by the Vice President of Claims
The PremiumAudit Assistant is responsible for administrative functions within the audit department. The primary role of the Premium Audit Assistant will be to maintain and improve the premium audit department by performing the following duties: providing customer service support, processing incoming/outgoing mail, working with in-house premium auditors and fee audit vendors to insure the timely return of field audits, reviewing and entering audit invoices, preparing payroll audit worksheets as necessary and other general duties as assigned and deemed necessary.
- Answer customer service calls regarding a variety of issues related to Underwriting, Premium Accounting and Audit.
- Process incoming/outgoing mail including audits received in our premium audit system, PATS
- Obtain audit statuses and assist auditors with the timely return of field audits and resolving any customer issues.
- Review and enter audit invoices.
- Maintain and keep current files of fee audit vendors.
- Prepare payroll audit worksheets as necessary.
- Assist premium audit analysts by providing administrative support.
Senior Risk Advisor, you would be responsible for analyzing losses to identify trends at individual businesses or within industries. This role will develop service plans for insured’s to eliminate or control causes of injury frequency and severity, safety management program deficiencies, manager/supervisor training and safety/regulatory program development. Communication is key as it will work closely with internal departments issues that pertain to risk assessment and selection and provide telephone consultation to insured’s on a variety of workers’ compensation risk management issues. The selected individual must be self-motivated and disciplined to work with minimal supervision to coordinate schedule, confirm meetings, and develop safety materials to educate, inform and motivate customer management. The Senior Risk Advisor is expected to exhibit a level of expertise in their area of responsibility, consistently exercising good judgment.
Responsibilities include but are not limited to:
- Support the underwriting process by identifying and describing risks and controls for various industries to underwriter.
- Assist with the education of underwriting and claims personnel to expand their knowledge of industry operations, loss sources and control mechanisms.
- Provide consultation to customers on a variety of workers’ compensation risk management topics.
- Analyze and interpret customer injury trends, then develop and implement service plans that improve the quality of the customer’s safety program.
- Confirm customer safety and health service visits, and follow-up on recommendations for completion.
- Create safety programs and materials for specific industries addressing actual/potential loss trends.
- Various safety and health duties as assigned.
A Business Systems Analyst is responsible for working directly with customers to provide support and product delivery across multiple business systems for our business partners. This role will lead efforts to collect/translate technical business requirements, test and deliver solutions. They will also be responsible for understanding business process flows, and how changes in corresponding systems may impact the applications they support. This person must be a highly motivated self starter and work independently with minimal direction.
- Ability to troubleshoot issues in response to user inquiries.
- Requires strong ability to manage and prioritize multiple tasks with competing deadlines.
- Serve as escalation point to research and resolve production support and configuration issues which cannot be resolved by initial triage.
- Individuals in this role are considered application experts and will need to answer “how to” questions in reference to the application.
- Provide recommendations on how to improve system applications, processes and tools
- Provide outstanding customer service
- Communication of expectations and status with members of the company
- Recreate issues and document requirements for bug fixes and/or system enhancements.
- Approximately 50% of tasks are technical in nature including Java development, building and deploying applications, production support, etc.
- Must be familiar with ALM processes
- The other 50% is devoted to analysis, testing, and helping business prioritize initiatives.
- Some travel is required (less than 10%).
The Preferred Employers Group, a W.R. Berkley company, is growing to support the needs of our business! The position reports to IT Director/IT Manager and will provide application design, development, enhancement, maintenance and testing support to one or more applications and business processes. The position will be accountable and responsible for developing, implementing and supporting business technology solutions for customers.
- Gain and maintain expert knowledge and understanding of systems, subsystems and interfaces.
- Effectively design, develop and troubleshoot application system problems by identifying and implementing software or process changes that allow business transactions to continue with minimal risk.
- Possess a deep understanding of vendor software integration and interactions within the domain
- Possess and maintain strong expertise in the use of tools/technologies used to manage data and infrastructure
- Be able to consider technical decisions during problem resolution, balancing standards, principles, and process.
- Be able to analyze, design and enhance software development/maintenance processes and procedures.
- Maintain a knowledge and awareness of emerging technology including hardware, software, services and development methods.