Auditor - Claims Operations
Agero
 Medford, MA

Department: Finance – Claims Operations


DESCRIPTION SUMMARY:Proactively evaluates invoice submissions from business partners to assess compliance with operational policies and procedures designed to enhance revenues, contain costs or improve operational effectiveness and efficiencies. Responsible for conducting audits for Claims Operations to assess effectiveness of advanced business rules/controls, accuracy of invoices and payments, compliance with rate agreements and regulations, gathering and analyzing audit evidence. Comprehends and interprets reject reasons and applies appropriately to Service Provider invoices. Corresponds with Service Providers for additional information needed to process payment. Perform value-added financial, operational, and compliance audits of complex audit projects

KEY COMPETENCIES:                                      


  • Service Oriented/Internal Customer Service

  • Teamwork

  • Interpersonal Communication

  • Fast & Flexible

  • Conflict Resolution

  • Resiliency

           ESSENTIAL FUNCTIONS:


  • Reviews submitted invoices and compares to published service provider rates, using mileage software and business rules in order to determine acceptance or rejection of payment on claim prior to processing.

  • Understands and interprets reject reasons and applies appropriately to service provider invoices.

  • Utilizes processing system to research all claims issues.

  • May authorize stop pay and re-issue of checks to service providers.

  • Researches incorrect purchase orders on service provider claims to determine validity of claim.

  • Corrects documentation to reflect actual service provider utilized during customer service call.

  • Analyzes data obtained for evidence of deficiencies in controls, duplication of effort, extravagance, fraud, or lack of compliance with policies or procedures.

  • Prepares and submits audit findings and makes recommendations to management.

SKILLS:


  • Demonstrates thoroughness, creativity, foresight, and use of sound business judgment in the application of invoice processing principles, corporate policies, and business practices

  • Possess excellent attention to detail and strong problem solving skills

  • Analytical ability

  • Strong PC skills, Technical skills required in word processing, spreadsheet software

  • Strong Time Management skills

  • Excellent oral and written communication skills

  • Must have self-motivation, initiative and ability to handle multiple projects simultaneously


WORKING RELATIONSHIPS: Communicates with associates, customers and service providers in a professional manner. Effectively teams with peers, supervisors and management to achieve corporate and client goals.   

ADDITIONAL REQUIREMENTS: Ability to work flexible schedule as business needs dictate. Demonstrates ability to work independently.

EDUCATION: High School Diploma/G.E.D or equivalent work experience.

EXPERIENCE: 1-2 years related work experience in fast paced data entry/transaction processing background and knowledge in automotive industry preferred.