The mission of the Idaho Industrial Commission is to fairly administer the Idaho Workers' Compensation Law
Idaho Industrial Commission Job Opportunity
The Idaho Industrial Commission is currently hiring for an Insurance Claims Auditor. An Insurance Claims Auditor is recognized for their broad technical expertise of insurance claims processes and procedures. Empowered to resolve conflicts, Insurance Claims Auditors work to establish cooperative working relationships with in-state claims administrator managers, and out-of-state claims and compliance managers to ensure top-down compliance with Idaho claims adjusting requirements. The Insurance Claims Auditor is authorized to negotiate with stakeholders to resolve areas of noncompliance in the administrative processes. They will provide training to claims administrators on Idaho requirements. May be involved in the interviewing,, hiring, evaluation, and supervision of staff.
Special Notification: This is a non-classified position and exempt from classified state service and the rules of the Division of Human Resources and the Idaho Personnel Commission.
Example of Duties:
Establishes processes to promote industry uniformity in the understanding of and compliance with Idaho claims adjusting regulations by claims administrators and Idaho-authorized sureties;
Meets with in-state and out-of-state decision-makers and negotiates as necessary to obtain compliance with claims adjusting requirements as such may arise as a result of new judicial decisions, advancing technology, or other causes;
Develops overall audit plan in conjunction with the Benefits Administration Manager; defines audit purpose, scope, objectives, time frames, and resources in order to complete audits in an effective and timely manner; and conducts site and desk audits as indicated to ensure compliance with Idaho statutes and administrative rules;
Reviews, prepares, and makes recommendations to the Commission on Settlement Agreements;
Provides telephonic assistance to injured workers, employers, claims administrator managers and their attorneys;
Conducts training presentations with in-state and out-of-state managers (as indicated) focused on areas of low-performance claims adjusting areas, issues of common non-compliance, and new administrative handlings of compliance issues.
Minimum Qualifications:
Four-year college degree in a related field (examples include business, accountancy, marketing, communications, English, political science, or finance); OR at least five years of recent (within the past 10 years) experience in the insurance industry; OR an associates level college degree in a related field (or a State or Idaho CPM certificate) and at least three years of work experience in the insurance industry; OR at least three years of work experience as a Benefits Analyst with the Industrial Commission;
Good knowledge of insurance, legal and medical terminology relating to workers' compensation or other medical claims;
Experience using basic audit procedures in a work setting;
Experience interpreting, explaining, and applying laws, regulations, and complex policies;
Experience in negotiating or mediating agreements and maintaining effective working relationships;
Experience providing training and/or oral presentations to groups;
Experience communicating verbally with a variety or people to effectively gather and transmit information;
Experience in positions that require accuracy, attention to detail, and good time management skills;
Some experience analyzing information and researching a variety of sources to identify and resolve problems or issues.
Desired Qualifications:
Good working knowledge of Idaho Workers' Compensation Laws (certification as an Idaho Workers' Compensation Specialist preferred);
Experience in the insurance industry;
Some mediation/negotiation experience;
Supervisory experience of professional staff;
Computer literacy (experience with MS Office Suite preferred);
Valid Driver's License
To learn more about the Idaho Industrial Commission, please visit our website (http://www.example.com) !
This position has great benefits including:
Participation in one of the Nation's best state retirement systems: PERSI (https://www.persi.idaho.gov/members-1)
An opportunity for Student Loan Forgiveness (https://studentaid.gov/pslf/)
11 paid holidays a year
Paid parental leave
Excellent Medical, Dental, and Vision (https://ogi.idaho.gov/benefits-plans/) plans
Sick and vacation leave that accrue as soon as you start
Optional 401K, and optional 457
Basic life insurance for employee and family
Wellness programs
Training opportunities
To be considered for this non-classified state position you must attach:
A letter of application (cover letter) - detailing your position-related background and experience, including identifying how you specifically meet the listed minimum qualifications.
A resume - outlining your experience and education
A list of three professional references.
Resumes and supplemental information will be reviewed to select the most highly qualified candidates to participate in an interview examination. Application materials will not be returned.
The State of Idaho is committed to providing equal employment opportunities and prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on their race, color, religion, political affiliation or belief, sex, national origin, genetics, or any other status protected under applicable federal, state, or local laws.The State of Idaho is committed to access and reasonable accommodations for individuals with disabilities, auxiliary aids and services are available upon request. If you require an accommodation at any step in our recruitment process, you are encouraged to contact (208) 334-2263 (TTY/TTD: 711), or email ada.coordinator@dhr.idaho.gov.Preference may be given to veterans who qualify under state and federal laws and regulations.
