Premium Audit & Account Resolution Specialist

Job Responsibilities and Requirements

JOB SUMMARY

The Premium Audit & Account Resolution Specialist is responsible for proactively reviewing premium and account activity to identify discrepancies, potential premium leakage, and accounts requiring further attention. The role manages an assigned portfolio of groups, conducts detailed premium and account reviews, analyzes reporting and account data, and determines appropriate next steps to resolve identified issues. This position works closely with policyholders, brokers, agents, and internal business partners to research and resolve complex premium and account matters and participates in special projects supporting Premium Services.

RESPONSIBILITIES & QUALIFICATIONS

Key Responsibilities

• Reviews reports, premium activity, life counts, and account information to identify discrepancies, unusual activity, and groups requiring additional review.
• Manages an assigned portfolio of groups and follows identified issues through research, outreach, and resolution.
• Conducts detailed premium audits and account reviews to validate premium calculations, payments, rates, life counts, and other relevant information.
• Analyzes account history and supporting data to identify the cause of premium discrepancies and determine appropriate next steps.
• Researches and resolves complex premium issues, including underpayments, overpayments, missing premium, reporting discrepancies, and other account variances.
• Works directly with policyholders, brokers, agents, and internal business partners to obtain information, clarify discrepancies, and resolve account issues.
• Uses reports and available data to identify trends, issues, and accounts that may require additional review or follow-up.
• Maintains accurate documentation of audit findings, outreach, follow-up activities, and resolutions.
• Identifies recurring issues and opportunities to improve premium accuracy, account resolution, or related processes.
• Participates in special projects, analyses, and initiatives supporting Premium Services.

Other duties as assigned.

Required Qualifications

or equivalent experience gained from any combination of formal education, on-the-job training, and/or work and life experience

• Insurance industry experience, preferably with New York DBL/PFL.
• Typically, 3+ years of experience in premium audit, billing, collections, underwriting support, policy services, finance, or related insurance operations preferred.
• Knowledge of payroll, wage reporting, premium calculations, account reconciliation, and audit follow-up preferred.
• Familiarity with NYS-45 and similar census/data reporting, along with proficiency in Excel, Word, and Copilot.
• Strong analytical, research, and problem-solving skills, including the ability to review information, identify issues, and determine appropriate next steps.
• Strong organization, follow-up, documentation, time management, and attention to detail, with the ability to manage multiple open items through resolution.
• Effective written and verbal communication and relationship-building skills, including working with policyholders, agents, brokers, and internal business partners while maintaining accuracy, accountability, and customer service.

Ability to Travel: Up to 10%

PHYSICAL REQUIREMENTS

When used in the description below, the following terms are defined as: “Occasional”: done only from time to time, but necessary when it is performed; “Frequent”: regularly performed; generally an act that is required on a daily basis; “Continuous”: typically performed for the majority of an employee’s shift.

Sitting for prolonged periods of time, frequently standing, walking distances up to one mile, bending, crouching, kneeling, reaching, occasionally lifting 25lbs, extensive typing, picking up and holding small objects, and otherwise using primarily the fingers rather than the entire hand. Employee is required to have visual acuity sufficient to perform activities such as preparing and analyzing data and figures; transcribing notes; viewing a computer terminal; and extensive reading. Employee is required to have hearing sufficient to understand verbal instruction and answer telephones. Reliance Matrix will provide qualified employees with a reasonable accommodation in accordance with applicable law.

The above description reflects the general details considered necessary to describe the principle responsibilities and functions of the job identified and shall not be construed as a detailed description of all the work requirements that may be inherent to this job.

The expected hiring range for this position is $27.88 - $34.85 hourly for work performed in the primary location (New York, NY). This expected hiring range covers only base pay and excludes any other compensation components such as commissions or incentive awards. The successful candidate’s starting base pay will be based on several factors including work location, job-related skills, experience, qualifications, and market conditions. These ranges may be modified in the future.

Work location may be flexible if approved by the Company.

What We Offer

At Reliance Matrix, we believe that fostering an inclusive culture allows us to realize more of our potential. And we can’t do this without our most important asset—you.

That is why we offer a competitive pay package and a range of benefits to help team members thrive in their financial, physical, and mental wellbeing.

Our Benefits:

• An annual performance bonus for all team members
• Generous 401(k) company match that is immediately vested
• A choice of three medical plans (that include prescription drug coverage) to suit your unique needs. For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account
• Multiple options for dental and vision coverage
• Company provided Life & Disability Insurance to ensure financial protection when you need it most
• Family friendly benefits including Paid Parental Leave & Adoption Assistance
• Hybrid work arrangements for eligible roles
• Tuition Reimbursement and Continuing Professional Education
• Paid Time Off – new hires start with at least 20 days of PTO per year in addition to nine company paid holidays. As you grow with us, your PTO may increase based on your level within the company and years of service.
• Volunteer days, community partnerships, and Employee Assistance Program
• Ability to connect with colleagues around the country through our Employee Resource Group program

Our Values:

• Integrity
• Empowerment
• Compassion
• Collaboration
• Fun

EEO Statement

Reliance Matrix is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability, or any other classification or characteristic protected by federal or state law or regulation. We assure you that your opportunity for employment depends solely on your qualifications.

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About Us

Reliance Matrix delivers employee benefits, absence management and workforce productivity solutions through the financial stability of a top-rated insurance carrier, the agility and innovative spirit of a Third Party Administrator (TPA), and the daily commitment of thousands of team members across America. Where larger competitors offer size, we inspire confidence and long term engagement through integration, reliability and dedication to providing customized solutions.

Reliance Matrix innovates and provides technology-driven absence and benefit solutions that enable employees and employers to manage time away from work.

We help employers attract and retain valuable human capital through thoughtful, inclusive benefit programs delivered with care.

We bring top-tier regulatory knowledge and cutting edge technology to help optimize workforce productivity and compliance.

We offer a seamless member experience customized to each individual’s need and event.

We integrate our solutions and expertise with leading HR technologies to ensure accuracy, efficiency and a superior customer experience.

We are a proud member of the global Tokio Marine Group, one of the oldest, largest and most respected insurance organizations in the world.

In the business hierarchy, human capital is the most precious of assets. Reliance Matrix delivers comprehensive, integrated solutions and services to attract, protect and help optimize an employer’s work force in a changing, challenging world.

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