Jobs · Customer Service

Health Claims Stop Loss Claims Auditor

Risk Strategies Company · United States · 2 wk ago
RemoteRemoteCustomer ServiceFull-time

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 spanning 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.

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