Reinsurance Claims Auditor

PRO IS Inc

13h • Remote

About The Position

PRO IS, Inc. has an exciting Claims Auditor position available within our Audit Team. The candidate has to have strong reinsurance and direct claims adjusting experience. This client-facing role would suit experienced, highly motivated candidates who are able to handle multiple demands with a sense of urgency, drive, and energy while growing and maintaining client relationships. This role is fully remote within the USA and may require travel.

Requirements

• 5+ years of (re)insurance claims experience, including demonstrable track record of auditing or quality assurance reviews.
• Strong evidence of business and client relationship development.
• Bachelor’s degree in business administration or similar field.
• One or more industry designations Chartered Property Casualty Underwriter (CPCU), Associate in Claims (AIC), Associate in Reinsurance (ARE), etc.
• Equivalent education, work experience, knowledge, and skills may qualify.
• Excellent working knowledge of reinsurance claims; having experience reviewing claims being submitted to our clients.
• Highly structured and conceptual mindset coupled with strong quantitative and analytical problem-solving aptitude.
• Excellent written and oral communication skills.
• Detail orientated, with excellent organizational and planning skills.
• Ability to work independently, with a team, and with initiative is essential.
• Ability to travel within the USA up to 10% of the time.

Responsibilities

• Perform multiple audit engagements and lifecycles at one time: overseeing the entire audit process including compiling data cedants or TPAs on claims handling structure and requesting information in preparation for the audit.
• Audit Cedants, TPAs and Client Claims Teams to ensure adherence to contractual agreements, SLAs and within industry standards and regulatory requirements.
• Review pre audit questionnaire (PAQ) responses and necessary documentation; drafting follow-up questions and inquiries as needed.
• Review direct and/or ceded claims submissions for accuracy, timeliness, and compliance with reinsurance contract terms (treaty and facultative, where applicable).
• Manage communication, preparatory, onsite/remote, wrap up, meeting, and post audit/reporting activities.
• Analyze claims handling practices through structured audit testing and sampling to identify systemic risks, deviations from contract terms, and exposure trends. Evaluate any liability or coverage decisions to evidence appropriate claims handling decisions.
• Prepare clear, defensible audit reports and executive summaries; support client read‑outs and respond to follow‑up inquiries regarding findings and recommendations.
• Liaise with Audit Administrator regarding audit preparations and reinsured/TPA readiness.
• Refer to Peer Reviewer before releasing to client.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 251-500 employees