Aggregate Claims Auditor
About The Position
This role involves analyzing aggregate stop loss high-level reviews and aggregate accommodation claims. The primary responsibility is to validate which expenses are eligible under the aggregate stop loss contract. The position also requires performing enrollment evaluations and calculations to ensure the correct attachment is applied. Additionally, the Aggregate Claims Auditor will produce deliverables related to audit findings, including audit reports for clients, exhibits, and non-exhibits within company-accepted timeframes. The role also encourages contributing innovative ideas and assisting with the implementation of new processes.
Requirements
- Excel proficiency including knowledge of basic or advanced Formulas and PIVOT Tables.
- Minimum 3-4 years of experience with self-funding in combination with specific stop loss claims, first dollar medical claims, aggregate claims, HMO reinsurance, and provider excess claims.
- Demonstrated proficiency in Microsoft Office including Microsoft Word and Outlook.
Responsibilities
- Analyze aggregate stop loss high level review and aggregate accommodation claims.
- Validate which expenses are eligible under the aggregate stop loss contract.
- Perform enrollment evaluation and calculations to ensure the correct attachment is applied.
- Produce deliverables related to audit findings including audit report for client, exhibits and non-exhibits within the company accepted timeframes.
- Contribute innovative ideas and assist with the implementation of new processes.
Benefits
- health insurance
- dental insurance
- vision insurance
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
