Hcc Risk Adjustment Coding Jobs in Michigan (NOW HIRING)

SUMMARY: (Brief 3-5 sentence paragraph outlining the main purpose of the job) 

Primarily responsible for evaluation, approval, completion and processing of mail audits and reviewing phone audits in a multi-functional business unit.  Provides direct customer service via phone, fax, and e-mail to internal and external customers including, but not limited to; Business Development Consultants and assigned risk representatives, finance, TPA representatives, and other premium audit staff, as well as agents, attorneys, NCCI / regulatory bureaus, and policyholders. Respond to telephone, mail, or email inquiries providing direct customer service to internal and external customers related to an audit and other policy concerns. 

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. 

1. Analyze, research, approve, complete and process mail audits. 

1. Analyze, research, approve, complete and process the following audit adjustment types: waive, mail, and phone audits.  When an adjustment is denied, notify the parties involved.  

1. Make necessary customer contacts to an insured, accountant, or agent to gather sufficient information to ensure the classifications are correctly applied on the audit/audit adjustment.  Identify correct classifications on the audit by researching PAAS, NCCI, and other applicable web tools. 

1. Analyze, research and communicate audit concession requests from external customers to relevant internal staff. Communicate final decision to external customers. Complete and process the concession adjustment, if approved by management. 

1. Analyze, research and communicate policy changes and omissions to relevant internal staff that include, but are not limited to, payroll, class codes, entity, states, Federal/Risk IDs, addresses, officers, endorsements, because of audit findings while completing the audit/audit adjustment. 

1. Manage workflow inventory to achieve specific time service goals. 

1. Estimate audits. 

1. Train and mentor the Premium Audit Technician position. 

1. Compose written correspondence, as appropriate. 

1. Maintain confidentiality of information processed. 

1. Work with minimum supervision. 

This description identifies the responsibilities typically associated with the performance of the job. The percentage of time in any responsibility may vary between positions.  Other relevant essential functions may be required. 

EDUCATION AND EXPERIENCE   

Relevant combination of education and experience may be considered in lieu of degree. 

1. EDUCATION REQUIRED: (Brief paragraph detailing the minimum education required, including certifications) Do not state preferred qualifications. 

High school diploma or G.E.D. Minimum 30 credit hours of course work in Accounting, Business, Insurance, Finance or related field.  Combinations of education and experience may be considered in lieu of education requirements. 

1. EXPERIENCE REQUIRED: (Minimum experience required to perform this job.) Do not state preferred experience. 

One-year experience as an Underwriting Technician II, or equivalent Enterprise experience that provides the necessary skills, knowledge and abilities.  

OR 

Two years of technical or administrative office experience, including relevant audit, payroll or underwriting duties in an insurance organization.  Two years of demonstrated experience of the necessary skills, knowledge and abilities required for the position may be considered.  

.  

QUALIFICATIONS 

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

OTHER SKILLS AND ABILITIES  

• Ability to work effectively in a multi-functional business unit. 

• Exhibits a basic knowledge of underwriting rules, procedures, manuals and Worker Compensation classifications in a single state and/or multiple states with similar state rules. 

• Excellent oral and written communication skills. 

• Excellent organizational skills and ability to prioritize work. 

• Ability to manage multiple priorities and meet established deadlines. 

• Basic knowledge of computers, word processing, spreadsheet software with accurate input ability of 40 wpm with ability to use 10-key.   

• Analytical and problem-solving skills. 

• Ability to proofread documents for accuracy of spelling, grammar, punctuation, and format. 

• Basic math skills. 

• Basic knowledge of payroll reports, payroll tax returns, tax forms and supporting documentation. 

• Develops and understands client/customer needs and initiates timely action to meet them. 

• Exhibits a basic understanding of one or more business functions and their processes. 

1. ADDITIONAL EDUCATION, EXPERIENCE, SKILLS, KNOWLEDGE AND/OR ABILITIES PREFERRED: (Briefly detail the preferred education, experience, skills, knowledge and/or abilities desired to perform this job, including certifications). These are in addition to the required qualifications - Do not state required qualifications. 

• One-year of experience in assigned risk business with the Accident Fund Insurance Company of America. 

• Ability to work effectively in a multi-functional business unit. 

• Basic knowledge of payroll tax records. 

• Basic knowledge of ACD line functionality 

• Basic knowledge of Outlook calendar functionality.