Boston, Massachusetts
Compliance Auditor Job Opening in Boston, Massachusetts - COMPLIANCE AUDITOR
Category: Non Exempt
Reports To: Director of Compliance Audit
Function:
Under supervision the Compliance Auditor (CA) conducts detail-level reviews of premium and claim data reported by member companies for commercial and private passenger auto policies. The CA often must adapt to vastly different voluntary rating manuals, wide-ranging types and amounts of documentation, occasional travel requirements, and amended procedures on an audit-by-audit basis. The CA is frequently relied upon to identify discrepancy sources between reported and audited data and refer to appropriate authority any issues or trends as early as possible.
The compliance audit program focuses on private passenger and commercial auditing of premium and claim data within an approved audit cycle. Focus audits are also conducted based on unique data quality issues that require a targeted audit approach. The CA should develop an understanding of their responsibilities within the established audit program. In particular, the CA will have frequent exposure to the Massachusetts Private Passenger and Commercial Statistical Plans, CAR?s Private Passenger and Commercial Rating Manual, the voluntary rating manuals of each audited company and Claims Performance Standards. The CA should also develop a working knowledge of CAR?s mainframe and LAN technology that support the audit process, the audited company?s premium and claim systems used to obtain source documentation, and the Registry of Motor Vehicles (RMV) as a corroborating audit source.
Responsibilities:
Participate in Hybrid Audit Program (HAP) audits of all companies writing and reporting private passenger automobile statistical data with specific emphasis on the verification of reported data through comparison to source documentation.
Audit all elements of premium and claim data that impacts the Massachusetts Automobile Insurance Plan (MAIP) quota share, rate making or statutory requirements. In general, these three responsibilities are the core functions of the HAP audit. Each element is audited at a measurable confidence level and at a standard error rate.
Verify that the audited private passenger company is in compliance with the so called Lane-Bolling law requiring that consumers are charged the lower of the company voluntary or the MAIP rate by the insurer writing the auto policy.
V erify that the audited private passenger company calculates premiums in compliance with its voluntary rates on file with the Division of Insurance (DOI). The CA uses an automated Excel rater that is developed to compare the statistically reported premium to the rating attributes and discounts detailed in the company rate filings.
Verify that that the audited private passenger company is in compliance with approved Claims Performance Standards (CPS) designed to control costs, ensure prompt customer service, timely payment of legitimate claims and prevent the payment of inflated, fraudulent or unwarranted claims.
Participate in commercial audits of all Servicing Carriers or voluntary companies writing and reporting commercial automobile statistical data, with specific emphasis on the verification of reported data through comparison to source documentation.
Verify that the audited Servicing Carrier is rating ceded policies in accordance with the CAR Commercial Automobile Manual. Utilize source documentation, company reporting systems and other available data verification options to test and develop the accurate premium.
Participate in Reinsurance Audits of companies reporting ceded automobile statistical data with specific emphasis on the verification of source documentation. These audits are developed to identify duplicate records that should not be included in CAR?s cash flow process.
Perform specific assignments which may include, but are not limited to, the participation in internal CAR audits, Unqualified Opinion statistical audits, focus audits arising out of data issues identified in any audit function, MAIP related, verification of bank statement reconciliation?s, educational seminars for companies requesting training and other audit related duties as directed.
Perform other internal or external analytical projects at the request of the Director of Compliance Audit.
The previous statements are intended to describe the general nature and level of work being performed by the person assigned to this job. They are not intended to be an exhaustive list of all responsibilities.
Qualifications:
BS in Math or other quantitative degree
Proficient in MS Excel with ability to:
Vlookup
Index formulas
MS Query
Conditional Formatting
Data Validation
Macros
Capable of reading & analyzing large sets of data
Knowledge of MS Access
Job Type: Full-time
Required education:
Bachelor's
Required language:
English
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