Health Claims Stop Loss Auditor

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

📋 Description

• Executes comprehensive audits of complex claims files to guarantee compliance, accuracy, and alignment with company policies and regulatory standards.

• Conducts thorough reviews of claims files to verify accuracy and adherence to compliance regulations.

• Record findings and offer suggestions for corrective measures.

• Detect patterns and work together with various departments to enhance claims practices.

• Assist with audit reporting and analytics.

⛳️ Requirements

• Bachelor's degree is preferred; certifications such as CPCU, AIC, or other insurance credentials are advantageous.

• 4 to 6 years of experience in claims or auditing.

• Strong knowledge of claims management and insurance regulations.

• Must be analytical, organized, and proficient in Excel and audit systems.

🏝️ Benefits

• Health Claims Stop Loss

• Flexible work arrangements

• Professional development opportunities

• Equal opportunity workplace