Insurance Internal Auditor - Experis : Job Details

Jefferson Wells is seeking an experienced Insurance Auditor with Life Claims expertise to join our team. The successful candidate will be responsible for evaluating, reviewing, and auditing life insurance claims to ensure accuracy, compliance with company policies, industry standards, and regulatory requirements. The auditor will analyze theclaims documentation and processes, identify discrepancies, and collaborate with various departments to ensure proper claims handling.

• Audit Life Insurance Claims: Conduct thorough audits of life insurance claims, including verifying claim amounts, beneficiary information, and policy terms.
• Ensure Compliance: Verify that claims comply with all relevant laws, regulations, and company policies. Identify discrepancies or fraudulent activities and report findings.
• Data Analysis and Reporting: Analyze claim data and prepare detailed reports summarizing findings, trends, and audit outcomes. Provide actionable recommendations for improvements.
• Documentation Review: Examine life insurance policy documentation, medical records, and other relevant materials to assess claim validity and processing.
• Risk Management: Identify risks related to claim handling, compliance issues, or operational inefficiencies and collaborate with management to mitigate these risks.
• Collaboration and Communication: Work closely with claims adjusters, managers, and other departments to resolve any discrepancies or issues identified during audits.
• Training and Guidance: Assist in providing training and guidance to junior auditors and other staff on audit processes, policies, and compliance requirements.
• Claims Process Improvement: Provide insights into process improvements to ensure more efficient and compliant claims processing.
• Internal Controls: Monitor and test internal controls to ensure that claims handling adheres to company standards.

• Education: Bachelor's degree in Business, Finance, Accounting, Insurance, or a related field. Relevant certifications (e.g., CPCU, AIC, or others) are a plus.

• Experience: At least 3-5 years of experience in life insurance auditing or claims management, with a deep understanding of life insurance policies, claims processes, and regulations.

• Knowledge: Strong knowledge of life insurance products, claims procedures, and regulatory requirements (e.g., state/federal regulations, company policies)

At Jefferson Wells (www.jeffersonwells.com), we've built a reputation for results-driven, innovative workforce solutions that help companies create competitive advantage. From basic to complex, we custom tailor our services to fit our clients' needs from interim and permanent professional talent resourcing to complete project solutions in the areas of risk & compliance, tax, finance & accounting and business optimization. Our professionals provide specialized industry and technical experience and expertise to our clients, enabling them to accelerate their business performance. We serve clients, including Fortune 500 and Global 1000 companies, from offices worldwide leveraging the workforce capabilities of the ManpowerGroup. Jefferson Wells is an Equal Opportunity Employer.