Premium Validation Program Analyst (Remote insurance role NE PA)

Overview

The Premium Validation Program Analyst supports ongoing modernization of premium validation and quality assurance processes. This role requires strong analytical skills, intellectual curiosity, and a continuous improvement mindset as the organization expands the use of data analytics, automation, and artificial intelligence.

Reporting to the Manager of Field Operations, the Analyst conducts independent review of PA & DE carrier audits for compliance with manual rules, classification assignments, payroll allocations, claims, unit reports, pricing programs, and experience/merit ratings. Work includes gathering information and verifying details using manual rules and standard premium auditing practices.

Responsibilities

• Analyze carrier-submitted premium audit data and supporting documentation to identify discrepancies, inconsistencies, potential errors, and opportunities to improve data quality.
• Review and analyze carrier audit worksheets, supporting documentation, and reported premium and exposure data for accuracy and compliance with applicable manual rules.
• Review and reconcile payroll, tax, accounting, and related financial records to verify remuneration inclusions, exclusions, and payroll allocations under applicable workers’ compensation rules, including verification of accompanying accounting records for accuracy and compliance.
• Prepare comparative audit worksheets using employer payroll records and independent verification sources, and document exceptions, discrepancies, and supporting evidence.
• Prepare clear, accurate, well-supported reports describing business operations, employee duties, audit findings, and recommended corrections.
• Submit work assignments by established departmental deadlines.
• Maintain accurate electronic workpapers and complete records of review procedures, supporting documentation, and conclusions.
• Conduct special reviews and cross-functional projects supporting audit operations, Classification, data management, and other departments as assigned.
• Apply critical thinking and professional judgment to evaluate audit findings, identify recurring issues, and recognize patterns that may warrant further review.
• Support modernization of the premium validation program by developing and refining data-driven review methodologies and quality assurance processes.
• Follow up consistently with employers to obtain additional information needed for review.
• Complete timely surveys for the Classification Department by conducting interviews with employers and utilizing various sources of data and related information.
• Conduct in-person reviews when necessary based on audit complexity, program requirements, or management direction.
• Maintain timely and consistent attendance.

Requirements

• Education: Bachelor's degree in business or related field preferred.
• Professional designation (APA and/or CPCU) is a plus.
• Experience: 2+ years of experience in premium auditing, insurance operations, accounting, compliance, data analysis, or a related analytical role.
• Experience reviewing and interpreting complex financial or insurance data, identifying discrepancies, and evaluating compliance with established rules or standards is desirable.
• Familiarity with workers’ compensation insurance is preferred.

Skills

• Strong analytical, investigative, reconciliation, and problem-solving skills, including the ability to identify discrepancies, evaluate information critically, and apply sound professional judgment.
• Strong organizational, communication, decision-making, self-discipline, and written skills; ability to work independently and adapt to varying situations.
• Effective professional communication with internal and external stakeholders.
• AI-curious, with a demonstrated interest in learning about artificial intelligence and its potential applications in improving business processes.
• Demonstrated initiative, intellectual curiosity, and a continuous improvement mindset.
• Technical competencies including Microsoft Office 365.
• Ability to communicate effectively with all levels of personnel and outside contacts.
• Ability to manage multiple assignments and prioritize tasks accordingly.
• Adaptable and receptive to new technologies, evolving processes, and innovative approaches to accomplishing work.

Preferred Qualifications

• Professional designation (APA and/or CPCU).
• Familiarity with workers’ compensation insurance.
• Experience reviewing and interpreting complex financial or insurance data.

Compensation & Benefits

Not specified.

Location

Not specified.