Premium Audit Operations Specialist II

The Premium Audit Operations Specialist II reviews and processes audit worksheets to ensure compliance with business rules and regulatory guidelines, handling adjustments and endorsements within authority limits. This role proactively communicates audit results to insureds and agents, resolves disputes, and coordinates the transition from audit completion to billing, including setting up payment plans and documenting agreements. The Specialist also contributes to process improvements by providing feedback and documenting best practices. Strong organizational skills, confidentiality, and the ability to build positive customer relationships—while managing multiple priorities and delivering complex information—are essential for success in this position.

Core Audit Operations & Processing

• Review and process completed audit worksheets from field, phone, mail, and virtual audits to verify compliance with established business rules and regulatory guidelines.
• Process audit adjustments within assigned authority limits and escalate complex cases appropriately.
• Identify correct classifications using PAAS, NCCI, and applicable state-specific tools across multiple jurisdictions.
• Analyze and communicate future policy changes to insureds and agents with clear explanations.
• Process endorsements within assigned authority limits.
• Ensure proper documentation of state regulations and premium audit standards.

Proactive Customer Communication & Engagement

• Conduct proactive outreach to insureds and agents via phone and email to explain audit results before billing occurs.
• Execute customer engagement cycles to ensure understanding and agreement with audit findings.
• Handle immediate dispute resolution during communication windows to prevent billing complications.
• Set up payment plans for eligible customers based on audit results.
• Compose professional written correspondence and conduct confident verbal communications.
• Build positive customer relationships while delivering potentially unwelcome news about additional premiums.

Billing Integration & Handoff Management

• Coordinate smooth transitions from audit completion to billing operations.
• Analyze insured payment histories and structures to inform billing decisions.
• Document customer agreements and payment arrangements for billing team follow-up.
• Ensure proper handoff documentation for seamless billing processing.

Process Development & Continuous Improvement

• Provide regular feedback on evolving procedures and process effectiveness.
• Participate in process development meetings and contribute improvement recommendations.
• Document best practices and lessons learned for future training materials.
• Support implementation of new technologies and process innovations.

Quality & Performance Standards

• Meet established deadlines and manage multiple priorities effectively.
• Maintain strict confidentiality of all processed information.

• Minimum 3-4 years as a premium auditor or premium audit reviewer.
• Proven experience with Workers' Compensation.
• Knowledge of NCCI, WCIRB, PCRB/DCRB rules and regulations.
• Experience with multi-state audit operations preferred.
• Customer service experience in insurance or financial services environments.

Technical Competencies:

• Strong understanding of premium audit procedures and regulatory compliance.
• Proficiency with classification systems (PAAS, NCCI) and state-specific tools.
• Experience with audit software systems and Google Workspace applications.
• Basic billing and payment processing knowledge.
• Ability to analyze accounting records and payroll documentation.

Communication & Customer Service Skills:

• Excellent verbal communication skills for customer phone interactions.
• Strong written communication abilities for professional correspondence.
• Proven ability to explain complex financial information clearly.
• Experience handling sensitive customer conversations about additional charges.
• Dispute resolution and negotiation capabilities.
• Cultural sensitivity and professional demeanor in diverse customer interactions.

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 align with the requirements of the role. All AI-reviewed applications are still subject to human oversight 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.