Specific Stop Loss Claim Auditor Intern

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. For over 30 years, CTI’s mission has been to help self-funded health plan sponsors reduce claim expense and improve service to their employees through independent audit and control of their third-party claim administration. Our philosophy of continuous quality improvement (CQI) techniques, combined with our statistical process control methodology, ensures a high degree of consistency in our approach to medical claim auditing. Efficient planning and maximized use of our proprietary systems and technology produce a streamlined audit product requiring fewer hours than competitors to complete.

About the role

This internship offers an excellent opportunity for students or early-career professionals interested in healthcare claims, insurance, data analysis, and auditing. The Specific Stop Loss Claim Auditor Intern will support the Audit Team by reviewing medical claim documentation, analyzing data, and assisting with stop loss claim audits. The intern will gain hands-on experience with healthcare claims administration, reimbursement methodologies, and audit processes while working alongside experienced professionals in the industry. The position is remote and approximately 20 hours per week, with flexible scheduling.

Responsibilities

• Assist with reviewing and auditing specific stop loss claim submissions.
• Validate claim documentation and supporting records for completeness and accuracy.
• Analyze medical and pharmaceutical claims data.
• Assist in identifying claim discrepancies, overpayments, and audit findings.
• Utilize Excel and other Microsoft Office applications to organize, analyze, and report data.
• Support auditors in preparing client reports and audit summaries.
• Participate in process improvement initiatives and special projects.
• Maintain confidentiality of protected health information (PHI) and sensitive client data.
• Communicate effectively with team members regarding audit findings and project status.

Requirements

Required Qualifications

• Currently a sophomore in college pursuing a degree in Healthcare or a Science-related field.
• Strong analytical and critical thinking skills.
• High attention to detail and strong organizational skills.
• Proficiency in Microsoft Office, particularly Excel, Word, and Outlook.
• Excellent written and verbal communication skills.
• Ability to work independently and manage multiple tasks in a remote environment.

Preferred Qualifications

• Coursework or internship experience related to healthcare, insurance, auditing, or claims administration.
• Familiarity with healthcare claims processing or medical billing concepts.
• Experience using Excel features such as formulas, sorting, filtering, and pivot tables.
• Exposure to healthcare reimbursement methodologies, including Medicare, DRG, or RBRVS.
• Experience with Microsoft Access or other database applications.

Pay

$19.00 per hour.

Benefits

• Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance
• Financial Benefits: ESPP; 401k; Student Loan Assistance; Tuition Reimbursement
• Mental Health & Wellness: Free Mental Health & Enhanced Advocacy Services
• Beyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts, and more

Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations.