Health Claims Stop Loss Claims Auditor

About the role

The Health Claims Stop Loss Claims Auditor conducts detailed audits of high-complexity claims files to ensure compliance, accuracy, and adherence to company procedures and regulatory requirements.

Responsibilities

• Perform in-depth claims file reviews for accuracy and compliance.
• Document findings and provide recommendations for corrective action.
• Identify trends and collaborate with departments to improve claim practices.
• Support audit reporting and analytics.

Requirements

• Bachelor's degree (preferred).
• CPCU, AIC, or other insurance certifications a plus.
• 4 - 6 years of claims or audit experience (specific stop loss or first dollar medical).
• Strong understanding of claims handling and insurance regulations.
• Proficiency in Excel/audit systems.

Qualifications

• Bachelor's degree (preferred).
• CPCU, AIC, or other insurance certifications a plus.
• 4 - 6 years of claims or audit experience (specific stop loss or first dollar medical).
• Strong understanding of claims handling and insurance regulations.
• Proficiency in Excel/audit systems.

Skills

• Claims handling knowledge.
• Insurance regulations understanding.
• Excel proficiency.
• Audit system proficiency.

Benefits

• Global presence with 700+ locations.
• Team of approximately 23,000 professionals.
• Scalable, innovative strategies for customers.
• Dedicated to delivering comprehensive and customized insurance solutions.

Pay

• TBD

Schedule

• TBD

Company

Brown & Brown, Inc. (NYSE: BRO) is a leading insurance brokerage firm delivering comprehensive and customized insurance solutions and specialization since 1939. With a global presence spanning 700+ locations and a team of approximately 23,000 professionals, we are dedicated to delivering scalable, innovative strategies for our customers at every step of their growth journey. Learn more at BBrown.com.