[Hiring] Premium Validation Program Analyst @be6ec846-37a1-475a-a89b-ee4073483f77

Role Description

The Premium Validation Program Analyst plays an important role in PCRB’s ongoing efforts to modernize its premium validation and quality assurance programs. The position requires strong analytical skills, intellectual curiosity, and a commitment to continuous improvement. As PCRB expands its use of data analytics, automation, and artificial intelligence, the successful candidate will be adaptable, comfortable with evolving technology, and enthusiastic about identifying new ways to improve the accuracy, efficiency, and effectiveness of the program.

The Premium Validation Program Analyst works under the supervision of the Manager of Field Operations and is responsible for reviewing PA & DE carrier audits for compliance with manual rules, classification assignments, payroll allocations, claims, unit reports, pricing programs, and experience/merit ratings. The Analyst gathers information and verifies using Manual rules and standard premium auditing practices. This position supports PCRB’s responsibility to promote the accuracy, consistency, and integrity of workers’ compensation premium and classification data through independent review and quality assurance.

• 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.
• Prepare comparative audit worksheets using employer payroll records and independent verification sources, documenting exceptions, discrepancies, and supporting evidence.
• Prepare clear, accurate, and well-supported reports describing business operations, employee duties, audit findings, and any recommended corrections.
• Prepare and submit all 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 the ongoing modernization of PCRB’s premium validation program, including the development and refinement of 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.
• Timely and consistent attendance.

Qualifications

• Bachelor's degree in business or related field preferred. Professional designation (APA and/or CPCU) a plus.
• 2+ years of experience in premium auditing, insurance operations, accounting, insurance operations, 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.

Requirements

• Strong analytical, investigative, reconciliation, and problem-solving skills.
• Strong organizational, communication, decision making, self-discipline, and written skills.
• Effective professional communication with various 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.
• Adaptable and receptive to new technologies, evolving processes, and innovative approaches to accomplishing work.