Aggregate Claims Auditor

This is a fully remote position, open to applicants in United States.

📋 Description

• Conduct a comprehensive review of aggregate stop loss data and accommodation claims.

• Determine which expenses qualify under the aggregate stop loss agreement.

• Execute enrollment assessments and calculations to verify the appropriate attachment is utilized.

• Generate audit deliverables, such as client audit reports, exhibits, and non-exhibits, within company-defined timelines.

• Offer creative solutions and support the implementation of new procedures.

⛳️ Requirements

• Proficient in Excel, including basic and advanced formulas as well as PivotTables.

• At least 3–4 years of experience in self-funding, particularly with stop loss claims, first-dollar medical claims, aggregate claims, HMO reinsurance, and provider excess claims.

• Skilled in Microsoft Office, including Microsoft Word and Outlook.

🏝️ Benefits

• An inclusive and equal opportunity workplace.

• Flexible remote work options.