Stop Loss Claims Auditor

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

📋 Description

• Conduct thorough reviews of claims files to ensure accuracy and compliance.

• Record findings and suggest recommendations for necessary corrective actions.

• Recognize trends and collaborate with various departments to enhance claim practices.

• Assist in audit reporting and analytics.

⛳️ Requirements

• Bachelor's degree preferred; CPCU, AIC, or other relevant insurance certifications are advantageous.

• 4 to 6 years of experience in claims or auditing, particularly in stop loss or first dollar medical.

• Solid understanding of claims handling processes and insurance regulations.

• Proficient in Excel and audit systems.

🏝️ Benefits

• The Health Claims Stop Loss Claims Auditor performs in-depth audits of complex claims files.

• Provides comprehensive and tailored insurance solutions.