Claims Audit Associate

Company



Munich Re Specialty - North America



Location



Princeton
, United States

The Company is open to considering candidates in Philadelphia (PA), Hartford (CT), and Princeton (NJ).

We are adding to our diverse team of experts and are looking to hire those who are committed to building a culture that enables the creation of innovative solutions for our business units and clients.

The Company

Welcome to Munich Re Specialty - North America, a leading specialty insurance provider dedicated to delivering exceptional underwriting, claims, and risk management expertise to our partners and customers. As a trusted industry expert, we offer a broad range of comprehensive and customized solutions, including casualty, professional lines, property, surety, and public entity coverages. With the financial strength and global resources of our A+ Superior (A.M. Best) rated organization, we provide unmatched stability and reliability. Our team is committed to superior service levels, a distinctive approach to specialty solutions, and a deep understanding of the complex risks our clients face. Join our team and be part of a dynamic and experienced organization that is shaping the future of specialty insurance in North America.

The Opportunity

Future focused and always one step ahead!

The Claims Audit Associate will be part of a team that performs compliance audits on domestic Third Party Administrators (TPAs) and Managing General Agents (MGAs) utilized by MRS - North America and UK operations for handling liability and property claims under delegated authority agreements. Responsibilities include but are not limited to performing regular audits (including analysis of policies and procedures, execution of audit workpapers, and preparation of audit reports) of TPA and MGA partners. The Claims Audit Associate directly supports Claims Audit Consultants to execute audit fieldwork, support the report writing process, completes follow up on issues identified within the audit, updates internal databases with key details from the audit.

Responsibilities

• Conducts remote (or on-site) audits to assess the TPA or MGA claims handling process, procedures, and controls.
• Reviews and analyzes claim files to ensure compliance with relevant laws, regulations, and industry standards, including adjuster licensing, regulatory reporting, adherence to anti-fraud requirements, internal controls, information security and privacy administration, management of loss funds, consistent observance of fair claims settlement practices regulations, and handling of consumer complaints.
• Evaluates TPA and MGA compliance with our claim services agreements. Identifying and documenting any non-compliance issues or areas for improvement. Completing audit workpapers and reports in a timely manner and completing any review notes from testing.
• Supports and creates materials for kick off meetings and exit meetings, preparation for walkthrough discussion questions, and communicating notes to Claims Audit Consultants and the Sr. Compliance Consulting Manager.
• Supports the Claims Audit Consultants to follow up on reviews of TPA and MGA partners to ensure that they have implemented corrective action and timelines agreed upon during the audit.
• Communicates results of the follow up on reviews to Claims Audit Consultant to ensure closure by the established due date.
• Updates internal databases with relevant audit details to ensure accurate audit tracking, action plan follow up, and reports.
• Participate as needed in TPA and MGA due diligence reviews in relation to new and existing business.

Qualifications

• Bachelor's degree in Accounting, Finance, Business, related field, or relevant work experience.
• 3+ years professional working experience in claims consulting/audit/process management. The following are preferred fields and backgrounds: internal auditor within financial institutions or insurance fields (claims auditing is a plus), compliance role within a heavily regulated industry (insurance, financial institutions, pharmaceuticals, etc.), claims operations or direct handling experience.
• Progress towards the competition of the following certifications is a plus: CPCU, AIC, ARM, CIA, or IAP.
• Baseline understanding of insurance regulations. Familiarity with industry best practices and emerging trends in insurance compliance.
• Strong analytical and problem-solving skills with the ability to interpret complex regulations.
• Strong written and verbal communication skills to convey audit findings and recommendations clearly and professionally.
• Meticulous attention to detail to ensure accuracy in audits and compliance assessments.
• Skilled with Microsoft Office including Access, Excel, PowerPoint, and Word.
• Self-motivated with strong organizational and time management skills to prioritize workflow and ensure duties and projects are completed by deadlines.

The Company is open to considering candidates in numerous locations, including Philadelphia (PA), Hartford (CT), and Princeton (NJ). The salary range posted below reflects market variations across various locations. The offer will be adjusted per geography.

The base salary range anticipated for this position is $72,000-$105,600, plus opportunity for company bonus based upon a percentage of eligible pay. In addition, the company makes available a variety of benefits to employees, including health insurance coverage, an employee wellness program, life and disability insurance, 401k match, retirement savings plan, paid holidays and paid time off (PTO).

The salary estimate is adjusted to reflect the varying market conditions across different locations, with the with the higher end being more aligned with the Princeton job market. Factors that may be used to determine your actual salary include your specific skills, how many years of experience you have and comparison to other employees already in this role. Most candidates will start in the bottom half of the range.

At Munich Re, we see Diversity, Equity and Inclusion as a solution to the challenges and opportunities all around us. Our goal is to foster an inclusive culture and build a workforce that reflects the customers we serve and the communities in which we live and work. We strive to provide a workplace where all of our colleagues feel respected, valued and empowered to achieve their very best every day. We recruit and develop talent with a focus on providing our customers the most innovative products and services.

We are an equal opportunity employer. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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