[Remote] Claims Payment Auditor Lead
Note: The job is a remote job and is open to candidates in USA. Gallagher Bassett is dedicated to helping clients navigate complexity and deliver impactful outcomes. They are seeking a highly analytical Claims Payment Auditor Lead specializing in Workers’ Compensation and Liability claims to audit high-risk payments and ensure compliance with best practices.
Responsibilities
• Conduct detailed audits of Workers’ Compensation and Liability claim payments with a strong fraud‑risk mindset and professional skepticism to identify, investigate, and escalate potential internal fraud, errors, and non-compliance with GB Best Practices
• Review supporting documentation—including invoices, medical bills, and settlement agreements—for accuracy, appropriateness, and alignment with policy
• Collaborate with adjusters, managers, and cross‑functional teams to resolve discrepancies and implement corrective actions
• Maintain current knowledge of jurisdictional regulations, industry trends, and best practices relevant to Workers’ Compensation and Liability claims
• Contribute to the development and enhancement of audit procedures to improve audit quality, consistency, and effectiveness
• Participate in special projects or process improvement initiatives as needed
Skills
• Associate degree in a related field
• 5–7 years of experience in claims auditing, Workers' Compensation, Liability claims, or a closely related discipline
• Strong understanding of Workers' Compensation and Liability regulations, claims processes, and industry standards
• Demonstrated analytical skills with exceptional attention to detail and accuracy
• Proficiency with audit software and Microsoft Office (especially Excel)
• Strong written and verbal communication skills
• High ethical standards and the ability to consistently apply professional skepticism
• Ability to work both independently and collaboratively
• Bachelor's degree in a related field
• Professional designations such as Certified Fraud Examiner (CFE) or similar
Benefits
• Medical/dental/vision plans, which start from day one!
• Life and accident insurance
• 401(K) and Roth options
• Tax-advantaged accounts (HSA, FSA)
• Educational expense reimbursement
• Paid parental leave
• Digital mental health services (Talkspace)
• Flexible work hours (availability varies by office and job function)
• Training programs
• Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing
• Charitable matching gift program
• And more...
Company Overview
• About Gallagher Bassett: We are the leading provider of claims and risk management services, helping people and companies prevent, manage and overcome the impact of risk. It was founded in 1999, and is headquartered in San Diego, California, USA, with a workforce of 5001-10000 employees. Its website is https://www.robanda.com/.
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Responsibilities
• Conduct detailed audits of Workers’ Compensation and Liability claim payments with a strong fraud‑risk mindset and professional skepticism to identify, investigate, and escalate potential internal fraud, errors, and non-compliance with GB Best Practices
• Review supporting documentation—including invoices, medical bills, and settlement agreements—for accuracy, appropriateness, and alignment with policy
• Collaborate with adjusters, managers, and cross‑functional teams to resolve discrepancies and implement corrective actions
• Maintain current knowledge of jurisdictional regulations, industry trends, and best practices relevant to Workers’ Compensation and Liability claims
• Contribute to the development and enhancement of audit procedures to improve audit quality, consistency, and effectiveness
• Participate in special projects or process improvement initiatives as needed
Skills
• Associate degree in a related field
• 5–7 years of experience in claims auditing, Workers' Compensation, Liability claims, or a closely related discipline
• Strong understanding of Workers' Compensation and Liability regulations, claims processes, and industry standards
• Demonstrated analytical skills with exceptional attention to detail and accuracy
• Proficiency with audit software and Microsoft Office (especially Excel)
• Strong written and verbal communication skills
• High ethical standards and the ability to consistently apply professional skepticism
• Ability to work both independently and collaboratively
• Bachelor's degree in a related field
• Professional designations such as Certified Fraud Examiner (CFE) or similar
Benefits
• Medical/dental/vision plans, which start from day one!
• Life and accident insurance
• 401(K) and Roth options
• Tax-advantaged accounts (HSA, FSA)
• Educational expense reimbursement
• Paid parental leave
• Digital mental health services (Talkspace)
• Flexible work hours (availability varies by office and job function)
• Training programs
• Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing
• Charitable matching gift program
• And more...
Company Overview
• About Gallagher Bassett: We are the leading provider of claims and risk management services, helping people and companies prevent, manage and overcome the impact of risk. It was founded in 1999, and is headquartered in San Diego, California, USA, with a workforce of 5001-10000 employees. Its website is https://www.robanda.com/.
Apply tot his job
Apply To this Job