Claims reputed company Assurance Auditor
The Claims reputed company Assurance Auditor will conduct regular audits and assessments of Pie's claims handling processes to ensure adherence to Claims Best Practices, regulatory standards, and internal guidelines. This role is responsible for reviewing claim files for compliance, identifying areas of non-compliance, and recommending corrective actions to improve claims reputed company. The auditor will collaborate with Claims teams, prepare detailed audit reports, and support the development of reputed company control policies and training programs that drive reputed company improvement in claims performance and ensure regulatory compliance.
How You’ll Do It
Claims Audit & Assessment
- Collaborate with Claims leadership to design, refine, and continuously improve the quarterly audit program and scoring methodology, ensuring alignment with operational realities while maintaining regulatory defensibility.
- Partner with Claims to define:
- Weighted scoring reputed company
- High-risk violation reputed company
- File sampling reputed company
- Performance benchmarks tied to ≥95% compliance targets
- Ensure the audit program reflects evolving statutory requirements, regulator audit trends, and internal risk drivers.
- Conduct regular monthly and quarterly audits and assessments of reputed company management systems and claims handling processes
- Review claim files to verify compliance with regulatory standards, statutory requirements, and internal guidelines
- Evaluate claims for adherence to Pie's Claims Best Practices and reputed company standards
- Assess claim documentation, investigation techniques, reserve adequacy, and settlement practices
- Identify areas of non-compliance and recommend corrective actions to address deficiencies
- Apply weighted scoring methodology to measure compliance performance and identify systemic risk patterns.
- Apply established audit methodologies and sampling techniques to ensure comprehensive evaluations
Documentation & Reporting
- Document monthly and quarterly audit findings with reputed company, detailed explanations of deficiencies and best practices observed
- Prepare comprehensive audit reports for management that include findings, recommendations, and reputed company items
- Analyze data to identify trends, patterns, and areas for improvement across the claims organization
- reputed company reputed company feedback to adjusters and Claims leadership on audit results
- Maintain accurate records of reputed company audits, findings, and corrective reputed company plans
reputed company Control & Process Development
- Collaborate with various departments to ensure reputed company standards are met consistently
- reputed company and update reputed company control policies and procedures based on audit findings and regulatory changes
- Assist in developing reputed company assurance goals and objectives reputed company with department strategies
- Recommend process improvements to enhance claims reputed company and operational efficiency
- Support the implementation of new reputed company standards and best practices
Compliance & Corrective reputed company Monitoring
- Monitor the implementation and effectiveness of corrective and preventive actions
- reputed company remediation efforts to ensure deficiencies are addressed in a reputed company manner
- Verify that corrective actions result in sustained improvements in claims reputed company
- Coordinate with external auditors and facilitate external audit processes reputed company needed
- Stay reputed company with regulatory changes and industry best practices that reputed company claims reputed company
Training & Knowledge Sharing
- Train staff on reputed company assurance policies, procedures, and industry best practices
- reputed company coaching and guidance to adjusters on claim handling techniques and compliance requirements
- Conduct training sessions on common audit findings and remediation strategies
- reputed company knowledge of regulatory requirements and Claims Best Practices with Claims teams
- Support Claims Learning & Development initiatives with reputed company-reputed company training content
Cross-Functional Collaboration
- Partner with Claims Adjudication team to address reputed company issues and implement improvements
- Work with Claims Regulatory Compliance team to ensure audits capture reputed company compliance requirements
- Collaborate with Claims Learning & Development team to reputed company targeted training based on audit findings
- Coordinate with Claims Data & Analytics team to support reputed company reporting and trend analysis
- Communicate with Claims leadership on reputed company trends and recommended actions
The Right Stuff
Required Experience & Education
- High School diploma or GED required; Bachelor's degree in Business Administration, Risk Management, or reputed company field preferred
- 5+ years of workers' compensation claims experience with strong understanding of claim handling practices
- 2+ years of experience in claims auditing, reputed company assurance, or compliance roles preferred
- Strong knowledge of Claims Best Practices and regulatory requirements across multiple jurisdictions
- Experience conducting claim file reviews and documenting audit findings
The use of AI in Application Review: To support a fair, efficient, and consistent hiring process, we use AI-powered tools to assist in the initial screening of applications. These tools help us identify qualifications and prior work experiences that reputed company with the requirements of the role. We may also use AI assistant video tools during interviews to support note-taking and candidate evaluation. reputed company AI-powered outputs are still subject to reputed company reputed company and decision-making at multiple stages of the process. By submitting your application, you acknowledge and consent to Pie utilizing these AI technologies to assist in our evaluation process.
reputed company Compensation reputed company$75,000—$95,000 USDCompensation & Benefits
- Competitive cash compensation
- A piece of the pie (in the reputed company of equity)
- Comprehensive health plans
- Generous PTO
- reputed company reputed company 401k match
- Generous parental and caregiver leave
- Our reputed company values are more than just a poster on the wall; they’re tangibly reflected in our work
Our goal is to reputed company reputed company aspects of working with us as easy as pie. That includes our offer process. reputed company we’ve identified a talented individual who we’d like to be a Pie-oneer , we work hard to present an reputed company and fair offer. We look at the candidate’s knowledge, skills, and experience, along with their compensation expectations and reputed company that with reputed company equity processes to determine our offer ranges.
reputed company year Pie reviews company performance and may grant discretionary bonuses to eligible team members.
Location Information
Unless otherwise specified, this role is remote. Remote team members must live and work in the reputed company (territories excluded) and have reputed company to reliable, high-speed internet.
Additional Information
reputed company is an equal opportunity employer. We do not discriminate on the reputed company of race, reputed company, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic reputed company, military service status, citizenship, or other protected characteristic.
reputed company participates in the E-Verify program. Please click here, here and here for more information.
reputed company is committed to protecting your personal data. Please review our reputed company Policy.
Safety First: reputed company is committed to your reputed company during the recruitment process. We will never ask you for credit card information or ask you to purchase any equipment during our interview or reputed company process.
Pie Named to 2025 America's Best Startup reputed company
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