Claims Auditor Lead

Introduction

At Gallagher Bassett, we’re there when it matters most because helping people through challenging moments is more than just our job, it’s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives. It takes empathy, precision, and a strong sense of partnership—and that’s exactly what you’ll find here. We’re a team of fast-paced fixers, empathetic experts, and outcomes drivers — people who care deeply about doing the right thing and doing it well.

Whether you’re managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence. Here, you’ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you’re here, you’re part of something bigger. You’re part of a team that shows up, stands together, and leads with purpose.

Role specifics:

Jurisdictions: United States

Location: This role is eligible for fully remote work.

Professional designations such as Certified Fraud Examiner (CFE) or similar is preferred.

We are seeking a highly analytical and professionally skeptical Claims Payment Auditor Lead specializing in Workers’ Compensation and Liability claims. In this role, you will audit high‑risk payments to identify potential fraud, errors, and non‑compliance with GB Best Practices. Your work directly supports the integrity of our claims payment processes and supporting our commitment to delivering exceptional service to our clients.

• Associate degree in a related field.
• 5–7 years of experience in claims auditing, Workers’ Compensation, Liability claims, or a closely related discipline.
• Strong understanding of Workers’ Compensation and Liability regulations, claims processes, and industry standards.

• Conduct detailed audits of Workers’ Compensation and Liability claim payments with a strong fraud‑risk mindset and professional skepticism to identify, investigate, and elevate potential internal fraud, errors, and non-compliance with GB Best Practices.
• Review supporting documentation—including invoices, medical bills, and settlement agreements—for accuracy, appropriateness, and alignment with policy.
• Collaborate with adjusters, managers, and cross‑functional teams to resolve discrepancies and implement corrective actions.
• Maintain current knowledge of jurisdictional regulations, industry trends, and best practices relevant to Workers’ Compensation and Liability claims.
• Contribute to the development and enhancement of audit procedures to improve audit quality, consistency, and effectiveness.
• Participate in special projects or process improvement initiatives as needed.

• Associate degree in a related field.
• 5–7 years of experience in claims auditing, Workers’ Compensation, Liability claims, or a closely related discipline.
• Strong understanding of Workers’ Compensation and Liability regulations, claims processes, and industry standards.
• Demonstrated analytical skills with exceptional attention to detail and accuracy.
• Proficiency with audit software and Microsoft Office (especially Excel).
• Strong written and verbal communication skills.
• High ethical standards and the ability to consistently apply professional skepticism.
• Ability to work both independently and collaboratively.

• Bachelor’s degree in a related field.
• Professional designations such as Certified Fraud Examiner (CFE) or similar.

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We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours.

On top of a competitive salary, great teams and exciting career opportunities, we also offer a…