Job Responsibilities and Requirements
JOB SUMMARY
The Premium Audit & Account Resolution Specialist is responsible for proactively reviewing premium and account activity to identify discrepancies, potential premium leakage, and accounts requiring further attention. The role manages an assigned portfolio of groups, conducts detailed premium and account reviews, analyzes reporting and account data, and determines appropriate next steps to resolve identified issues. This position works closely with policyholders, brokers, agents, and internal business partners to research and resolve complex premium and account matters and participates in special projects supporting Premium Services.
RESPONSIBILITIES & QUALIFICATIONS
Key Responsibilities
Reviews reports, premium activity, life counts, and account information to identify discrepancies, unusual activity, and groups requiring additional review.
Manages an assigned portfolio of groups and follows identified issues through research, outreach, and resolution.
Conducts detailed premium audits and account reviews to validate premium calculations, payments, rates, life counts, and other relevant information.
Analyzes account history and supporting data to identify the cause of premium discrepancies and determine appropriate next steps.
Researches and resolves complex premium issues, including underpayments, overpayments, missing premium, reporting discrepancies, and other account variances.
Works directly with policyholders, brokers, agents, and internal business partners to obtain information, clarify discrepancies, and resolve account issues.
Uses reports and available data to identify trends, issues, and accounts that may require additional review or follow-up.
Maintains accurate documentation of audit findings, outreach, follow-up activities, and resolutions.
Identifies recurring issues and opportunities to improve premium accuracy, account resolution, or related processes.
Participates in special projects, analyses, and initiatives supporting Premium Services.
Other duties as assigned.
Required Qualifications
or equivalent experience gained from any combination of formal education, on-the-job training, and/or work and life experience
Insurance industry experience, preferably with New York DBL/PFL.
Typically, 3+ years of experience in premium audit, billing, collections, underwriting support, policy services, finance, or related insurance operations preferred.
Knowledge of payroll, wage reporting, premium calculations, account reconciliation, and audit follow-up preferred.
Familiarity with NYS-45 and similar census/data reporting, along with proficiency in Excel, Word, and Copilot.
Strong analytical, research, and problem-solving skills, including the ability to review information, identify issues, and determine appropriate next steps.
Strong organization, follow-up, documentation, time management, and attention to detail, with the ability to manage multiple open items through resolution.
Effective written and verbal communication and relationship-building skills, including working with policyholders, agents, brokers, and internal business partners while maintaining accuracy, accountability, and customer service.
Ability to Travel: Up to 10%
PHYSICAL REQUIREMENTS
When used in the description below, the following terms are defined as: “Occasional”: done only from time to time, but necessary when it is performed; “Frequent”: regularly performed; generally an act that is required on a daily basis; “Continuous”: typically performed for the majority of an employee’s shift.
Sitting for prolonged periods of time, frequently standing, walking distances up to one mile, bending, crouching, kneeling, reaching, occasionally lifting 25lbs, extensive typing, picking up and holding small objects, and otherwise using primarily the fingers rather than the entire hand. Employee is required to have visual acuity sufficient to perform activities such as preparing and analyzing data and figures;…