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Marsh McLennan Agency · 1 day ago

Claims Audit Director

Conshohocken, PA

Full-time

Hybrid

Mid, Senior Level

$90K/yr - $120K/yr

7+ years exp

Marsh McLennan Agency is a leader in the employee benefits marketplace, committed to making a difference for their colleagues and clients. The Leave and Disability Claim Audit Director is responsible for overseeing the audit function within the Absence, Disability and Life Center of Excellence, ensuring compliance and enhancing the efficiency of claim management.

Employee BenefitsHealth CareInsuranceRetirement

Growth Opportunities

Responsibilities

Identify and maintain the audit universe, and execute the annual audit calendar for absence, disability, life and voluntary benefit clients

Oversee scoping decisions, audit opinions, issue identification, severity assessment, and remediation tracking. Manage auditors to ensure consistent quality and adherence to internal audit methodology

Ensure compliance with federal, state, and local laws such as FMLA, ADA, PDA, PWFA, USERRA, and other relevant leave laws. Stay current with trends and legislation related to disability claims management and accommodations

Conduct comprehensive reviews and gap analyses of leave and other benefit processes to ensure compliance

Maintain relationships with management-level leaders and business partners, both internally and externally

Provide reports and analysis of trends, including gap analysis within disability management programs (Leaves/STD/LTD/Accommodation/WC) as well as other benefits

Provide high-level direction, develop long-range goals and objectives, and coach and mentor audit staff

Identify and lead resolution of service issues or contract misalignments

Qualification

LeaveDisability lawsAudit managementLeadership capabilitiesAnalytical skillsProject managementMicrosoft OfficeHR Information SystemsCase Management systemsCommunication skillsProblem-solving skills

Required

Bachelor's Degree or equivalent experience preferred

3-5 years of progressive experience managing quality assurance and/or audit functions

7-10 years of relevant leave and disability industry experience with leadership experience preferred

Strong analytical, problem-solving, and decision-making skills

Excellent communication, presentation, and interpersonal skills

In-depth knowledge of federal, state, and local leave and disability laws

Proficiency in Microsoft Office, HR Information Systems, and Case Management systems

Proven leadership and management capabilities with the ability to inspire and motivate teams

High organizational awareness and ability to partner effectively across all levels

Ability to maintain strict confidentiality

Strong project management skills

Knowledge of internal audit standards and methodologies

Strong organizational, management and account planning skills with analytical skills and strong attention to detail

Work in a high production team environment with a high degree of complexity

Operate independently and provide appropriate information and direction to other individuals

Provide effective, accurate, clear communication to internal company team members and clients

Ability to interact in a professional manner with clients, vendors, carriers and internal departments including sales, marketing, HR, Finance, IT and other functional areas within MMA East and designated key accounts

Ability to interact with and focus on information gathering and collaborative solution development in a proactive manner

Ability to handle sensitive and confidential information

Ability to lead team development and motivate others

Project management capability

Excellent troubleshooting, decision making and problem-solving skills

Ability to work well independently and as a team member; multitask and successfully operate in a fast-paced work environment; prioritize projects and meet deadlines

Ability to follow through on and successfully execute tasks while adhering to specified quality standards

Proficiency in use of PC such as keyboard skills and electronic folder/file organization and management

Aptitude for learning internal systems, applications and internal workflow of the department

Must be able to effectively interact and deal with people at all levels inside and outside of the company

Preferred

Certifications such as Certified Employee Benefit Specialist (CEBS), National Institute of Disability Management and Research (NIDMAR), or Certified Internal Auditor (CIA) preferred, but not required

Advanced degrees in Rehabilitation Counseling, Social Work, Psychology, or related fields preferred, but not required

Benefits

Health and welfare benefits

Tuition assistance

401K savings

Other retirement programs

Employee assistance programs

Company

Marsh McLennan Agency

Glassdoor4.4

Marsh McLennan is an insurance company that provides business insurance, employee benefits, and private client insurance solutions. It is a sub-organization of Marsh & McLennan.

Founded in 2003

White Plains, New York, USA

10001+ employees