An Insurance Auditor is a premium auditor, who undertakes the job of reviewing business documents and financial records of the company and ensures paying the proper amount of insurance premiums. Other core duties are listed on the Insurance Auditor Resume as – determining the worker’s compensation and liability insurance; auditing payroll and personnel records, collecting and analyzing data to detect deficient controls, duplicated efforts, and non-compliance with laws, regulations, and management policies; conferring with company officials about financial and regulatory matters, examining and evaluating financial and information systems, recommending controls; and examining inventory to verify journal and ledger entries.
Those at this position normally possess the following core skills – working knowledge of relevant software, excellent customer service skills, strong math, and accounting skills, accurate data entry skills, and sound independent judgment abilities. Insurance companies want their auditors to have at least a degree in accounting, finance, or economics.
Objective : Motivated Insurance Auditor with over 4 years of customer service in a face past environment. Dedicated customer service representative with the motivation to maintain customer satisfaction and contribute to company success. Excellent communicator with 2+ years of experience working in a demanding call center environment as a customer service representative.
Examine claims forms and other records to determine insurance coverage.
Obtain credit information from banks and other credit services.
Process and record new insurance policies and claims.
Correspond with insured or agent to obtain information or inform them of account status or changes.
Collect initial premiums and issue receipts.
Modify, update, and process existing policies and claims to reflect any change in beneficiary, amount of coverage, or type of insurance.
Prepared personal and business income taxes.
Experience
2-5 Years
Level
Junior
Education
B.A. In Communications Candidate
Insurance Auditor Resume
Headline : Strongly driven team player with superior interpersonal communication skills. Actively seeking career opportunities in the Communication field to fulfill best corporate qualities post-graduation July 2015 with a supportive Bachelor's degree.
Monitor and evaluate monitored call center agent calls in accordance with UPMC Health Plan guidelines.
Identify error trends to make recommendations regarding customer service training needs.
Participate in all training programs to develop a thorough understanding of the materials presented to the customer service staff.
Maintain or exceed designated quality and production goals.
Responds to the needs of internal Health Plan Departments.
Maintain employee/insured confidentiality.
Train new employees in all phases of company protocol.
Experience
5-7 Years
Level
Executive
Education
B.S. In Mass Media And Corporate Communication
Insurance Auditor Resume
Objective : Insurance Auditor is responsible for the ethical and legal compliance of insurance products in the United States and Canada. They are accountable for ensuring that insurance policies meet all applicable laws, regulations, and guidelines. They also ensure that any claims made against the insurance company are processed appropriately, and that all necessary information is obtained from customers prior to filing any claims.
Skills : Marketing Strategy, Analytical, Business Development.
Description :
Daily research and auditing of client accounts within over 50 banks and credit unions.
Call clients and loan officers to verify/transfer information.
Complete reports and notice worksheets; Process payment information and forced placed policies for various accounts.
Answer incoming calls and make outgoing calls to clients.
Explain products, procedures, and next steps.
Investigate insurance policies to confirm accurate coverage has been issued to cover the banks and credit unions.
Scanning artifacts and creating digital files of old records.
Experience
2-5 Years
Level
Junior
Education
Project Management
Insurance Auditor Resume
Summary : Maintain accounts for physicians for reimbursement from insurance companies and patients. Process incoming correspondence entering payments, adjustments, refunds, and update information. Counsel patients with questions or problems. Work outside agencies for collections. Working knowledge of ICD-9, ICD-10, and CPT-4 codes.
Skills : Microsoft Office, Excel, Retail Management, Data Entry, Customer Service.
Description :
Performed audits for an independent insurance auditing firm that worked for several insurance companies.
Policies audited were mainly worker's compensation and liability.
Travel to different businesses that were insured by our clients and audit various records, including payroll and sales records.
Determine how much these businesses owed our clients for the different insurance policies they carried.
Scheduled the appointments, met with the businessmen and audited the necessary records, summarized findings (determined what the premium was), and remitted results to our clients.
Investigate medical claims and determine what carrier pays as primary.
Recoup all money paid out if it is determined that the wrong carrier paid.
Experience
10+ Years
Level
Management
Education
BS In Accounting
Insurance Auditor Resume
Summary : Insurance Auditor is responsible for reviewing and validating the financial performance of insurance companies. This includes reviewing the financial statements and analyzing the key financial performance indicators to determine if there is a cause for concern.
Calculated and analyzed all contracts with insurance companies.
Analyzed charges on the itemized statements, review statements for daily accounts.
Researched problem accounts and filing.
Process insurance audits for 26 local franchises.
Answer phones, expense reports, training for new franchises.
Chemical and product inventory, assist in payroll.
Auditor Verification of reported payrolls and sales Assignment of payrolls and sales to classifications Computer - Windows 98 audit report program.
Experience
10+ Years
Level
Senior
Education
BS In Accounting
Insurance Auditor Resume
Summary : Insurance Auditor is responsible for collecting and verifying data from insurance companies, performing statistical analysis of the data and preparing reports that present findings. The Auditor is also responsible for performing audits of insurance companies and preparing reports to meet regulatory requirements.
Skills : Coordinating, Planning, Managing, Strong Leadership, Team Player.
Description :
Reviewed medical documentation and doctor prescriptions to determine whether certain medical procedures would be covered by the insurance company.
Scheduled audit appointments with clients.
Examined client's records regarding insurance policies.
Completed insurance audits and transfer to the company.
Gathered audit information over the phone.
Wrote of completed audits in FA3 Independent worker and self-motivation.
Rewarded work in a productive and creative environment.
Experience
10+ Years
Level
Senior
Education
BS In Accounting
Insurance Auditor Resume
Summary : Insurance Auditor is responsible for identifying and verifying the validity of insurance policies, Auditor also works with insurance companies to benchmark their products on a variety of criteria, including financial risk, service quality and value.
Skills : Payroll journals, General Ledgers, Cash Receipts.
Description :
Setup workers comp and general liability audit appointments with the insured via letters, phone, and email.
Called agent to notify insured.
Responsible for auditing insurance for patients on a daily basis.
Requires great attention to detail and the ability to research in order to collect, prepare, and organize the proper insurance information.
Document control.
Coordinated and executed on-site field audits of Workers Comp insurance policies of businesses.
Worked collaboratively with peers, customers, and stakeholders.
Experience
10+ Years
Level
Senior
Education
BS In Accounting
Insurance Auditor Resume
Summary : Qualified Insurance Auditor seeking a position in which to put my analytic skills and experience to work for right company. Sound knowledge of insurance operations including claims, enrollment and underwriting.
Skills : General Ledgers, Cash Receipts, and Disbursement Journals.
Description :
Coordinated and executed on-site physical workers Comp and General liability audits of small and large businesses.
Methodically and systematically analyzed Payroll journals, Financial Report.
Investigated and utilized the classification guidelines according to NCCI WC Manual Rules, and PAAS bulletins, to help determine actual exposure.
Investigated medical claims and determine what carrier pays as primary.
Assisted in the contracting and credentialing of primary and specialty care physicians and contracting with ancillary service providers.
Provided support to other areas of the department in identifying and addressing opportunities for process improvement relating to managed care.
Effectively communicated in a variety of settings, including presenting technical information.
Experience
10+ Years
Level
Senior
Education
Project Management
Insurance Auditor Resume
Summary : Insurance Auditor is responsible for the audit of insurance products and services to ensure that the products meet the needs of its clients. The Auditor must be able to independently analyze and evaluate account information, pricing, and claims data in order to identify potential problems with products or services.
Provides support to Facility CFO and submits reports of analytical findings.
Audited various forms of businesses and government entities including those in manufacturing, commercial and residential contractors, mercantile.
Independent Insurance Premium Auditor for various general liability and workers compensation insurance underwriters.
Review and verify data, such as age, name, address, and principal sum and value of the property on insurance applications and policies.
Completes established competencies for the position within the designated introductory period.
Part-time work involving the auditing of company payroll and sales data for workers' compensation and general liability insurance policies of companies.
Interpreted, applied, and enforced laws, rules, and regulations.
Experience
10+ Years
Level
Senior
Education
Project Management
Insurance Auditor Resume
Summary : Insurance Auditor is responsible for the performance of the Insurance Audit function. Identifying and evaluating risk within the insurance products by analyzing data from internal and external sources.
Skills : Managing Skills, HR.
Description :
Planned and organized daily trips to conduct audits on adjustable commercial accounts.
Reviewed financial statements, such as payroll records, general ledgers, and cash disbursement journals to ensure that casual and subcontract labor was covered by workmen's compensation and to capture any unreported exposures.
Interviewed upper management or appointed representatives to classify employee's jobs and duties to ensure all employees were correctly identified and defined.
Summarized audit information using industry and governmental rules and regulations.
Process insurance audits; physical, phone, and mail audits, for insurance carriers in the local area.
Full-charge bookkeeper; accounts payables, accounts receivables, payroll, and bank reconciliations.
Maintained human resources files and workers' compensation claims.
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