Should Internal or External Auditors Be Used to Audit Your Organization Workers Comp Program

If you had poor morale in the workplace, they would probably tell an external auditor before they would tell an internal one. You would be able to pinpoint the problems, perhaps more easily, but it wouldn’t be as objective.

A mix of internal and external auditing is essentially what happens because people in a company are almost always aware of why their problems are problems; they’re just not always willing to share it.

It’s most important, that somebody is gathering an objective opinion.
There are people inside who can be very objective.

Four Tips to Find an Outside Auditor:

1. Go to somebody who’s an expert in the field of workers’ compensation, open-minded, has good analytical skills, as well as good writing skills-because they’re going to have to write a report.
2. Be sure you auditor has a team approach.
3. Look at the time frame and determine how quickly a company could commit to doing the work.
4. Examine your comfort level — some of the touchy-feely stuff. Do you feel you can work well with the interviewer?
5. It’s best if the auditor has experience in health benefits or employement issues if they do not have expertise in workers’ compensation. First priority is to have an auditor with workers’ compensation experience, whenever possible. And, make SURE the auditor has some common sense, especially if they don’t have workers’ comp experience.

Four Tips for Finding your Internal Auditor:

1. Anyone who touches the workers’ compensation or the benefits is a possibility.
2. Human resources often have valuable insights.
3. Consider the managers of the following groups: safety, employee benefits, workers’ compensation and risk management.
4. Involve labor, not only the director of labor relations, but also the union business agent to get their perspective.

Five Things your Auditors Should Look Into

1. Do you have claims or do you have injuries? If you have a lot of claims, but you don’t feel they’re legitimate injuries, then you wouldn’t focus on a safety program. You’d focus on a fraud control program. 2. Address the insurance company relationship and return to work. Delve into the return to work. How long are employees out? How do they get them back to work?
3. Look at medical cost containment issues – what vendors or services are being used in the medical cost containment area and how effective are they? Include pharmacy expenses in the audit.
4. Is there fraud and what type of fraud is it?
5. How is your company communicating the policies? A lot of companies have good policies, but they just don’t tell anybody.

Having an excellent audit process is crucial. Your vendors will all perform better if they know YOUR audit process will be checking on THEIR performance.

WC Books: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php
WC Calculator: http://www.reduceyourworkerscomp.com/calculator.php