07/22/1995 70394

STATE WORKERS' INSURANCE FUND AUDITING SUPERVISOR

DEFINITION: This is technical and supervisory work in the review and processing of payroll records in order to recommend premium and policy modifications for policyholders covered under the State Workers' Insurance Fund.

An employee in this class supervises S.W.I.F. Auditing Technicians engaged in the review of claims data and employer payroll records to evaluate the appropriateness of the policy's employee work classifications, experience modification factors, and policy premiums. Work is performed within the framework of the rules and regulations issued by the Pennsylvania Compensation Rating Bureau, the Coal Mine Rating Bureau, the Pennsylvania Workers' Compensation Law, and S.W.I.F. operating procedures. Work involves interpretation and explanation of regulations, policies, guidelines and administrative processes and methods to employers, insurance brokers, and other concerned parties. Supervision includes planning, organizing and assigning work; determining work priorities; evaluating employee performance and preparing and signing Employee Performance Reviews; resolving grievances and complaints; interviewing and recommending employee selection; approving/disapproving leave; and evaluating training needs of subordinates. Work is performed under the general direction of the quality assurance manager and is reviewed for conformance to departmental policies and program objectives through reports and conferences.

EXAMPLES OF WORK: Participates in the development and application of procedures pertaining to the State Workers' Insurance Fund payroll auditing function.

Supervises the work of S.W.I.F. Auditing Technicians engaged in the review of claims data and employers payroll records to evaluate the appropriateness of the policy's employee work classifications, experience modification factors, and policy premiums in conformance with the rules and regulations of the Pennsylvania Compensation Rating Bureau, the Coal Mine Rating Bureau, the Pennsylvania Workers' Compensation Law, and S.W.I.F. operating procedures. Makes independent decisions concerning the most appropriate procedures to be followed in meeting objectives and/or resolving problems with the policyholder payroll auditing function.

Answers correspondence in writing and by telephone by disseminating responses that are in accordance with applicable administrative and legal constraints.

Serves as liaison with data processing and other departmental units to resolve problems and to insure a smooth processing flow of work.

Explains administrative and S.W.I.F. program policies, rules, regulations, standards, and objectives to subordinates.

Plans and organizes work, assigns work, determines work priorities, and reviews work performance of staff.

Evaluates employee performance and prepares and signs Employee Performance Reviews.

Receives grievances and complaints, conducts initial investigation into causes and conditions, discusses with employee, and resolves or recommends solutions to grievances and complaints.

Interviews prospective employees and recommends employee selection or ranks applicants in terms of preferability for employment.

Interprets contractual and administrative rights and obligations for subordinates and modifies work environment or process to conf form to changing conditions.

Approves or disapproves leave requests.

Initiates corrective disciplinary action for minor misconduct by subordinates and recommends major corrective disciplinary action or dismissals.

Evaluates educational training needs of subordinates and requests further education and training courses for subordinates.

Testifies as a material witness in legal proceedings.

Employees in this class may participate in the performance of their subordinates work consistent with operational or organizational requirements.

Performs related work as required.

REQUIRED KNOWLEDGES, SKILLS, AND ABILITIES: Knowledge of the Pennsylvania Workers' Compensation Law, rules and regulations of the Pennsylvania Compensation Rating Bureau and Coal Mine Rating Bureau, and State Workers' Insurance Fund procedures and guidelines pertaining to the assessment of experience modification factors, claims data, and employer payroll work classification allocations depicted in policies for Workers' Compensation Insurance coverage with the State Workers' Insurance Fund.

Knowledge of the principles and practices of casualty insurance auditing.

Knowledge of the basic provisions of casualty insurance policies and related forms.

Ability to interpret and comprehend basic casualty insurance related terms and data.

Ability to interpret and apply the provisions of Pennsylvania Workers' Compensation Law, the rules and regulations of the Pennsylvania Compensation and Coal Mine Rating Bureaus, and State Workers' Insurance Fund procedures and guidelines pertaining to the assessment of experience modification factors, claims data, and employer payroll work classification allocations depicted in policies for Workers' Compensation Insurance coverage with the State Workers' Insurance Fund.

Ability to ascertain facts and secure information through personal contact.

Ability to comprehend and learn to apply provisions of applicable collective bargaining agreement in relation to rank and file employees.

Ability to learn to evaluate employee performance and prepare employee performance evaluation reports.

Ability to learn to act judiciously in considering employee complaints, making adjustments, and recommending decisions on formal grievances.

Ability to establish and maintain effective and cooperative working relationships with employers, insurance brokers, staff members, and other governmental and private agencies.

Ability to use specialized automated office procedures, practices and equipment used to initiate changes stemming from payroll audits.

Ability to present ideas, methods, procedures, and instructions related to a processing function, clearly and effectively, orally and in writing.

Ability to organize, analyze, and evaluate payroll information obtained from State Workers' Insurance Fund policyholders and draw sound technical conclusions.

MINIMUM EXPERIENCE AND TRAINING: Two years of experience as a State Workers' Insurance Fund Auditing Technician;

or

Four years of casualty insurance auditing and/or underwriting experience, two of which included coverage in Pennsylvania, which included the assignment of classifications and application of proper rates, premium computations, policy assessment, and the issuance of new or revised policies;

or

Any equivalent combination of experience and training which included the two years of auditing and/or underwriting experience for casualty insurance coverage in Pennsylvania.