Aggregate Stop Loss Claims Auditor

Brown & Brown Insurance

2d•$75,000 - $90,000

About The Position

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Brown & Brown is seeking an Aggregate Stop Loss Claims Auditor to join our growing team!

Requirements

Excel Proficiency to include knowledge of Basic or Advanced Formulae and PIVOT Tables.
Minimum 3-4 years of experience with self-funding plus specific and/or aggregate claims; or reinsurance claims.
Demonstrated proficiency in Microsoft Office, to include Microsoft Word and Outlook.
Demonstrated strong analytical/critical thinking skills.
Demonstrated organizational skills, time management skills and detail‐oriented focus.
Strong written and verbal communication skills.
Ability to work independently with minimal supervision.

Nice To Haves

Prior experience with self-funding and the stop loss product.
Prior experience reviewing and/or auditing aggregate stop loss claims.
History of successful Process Improvement initiatives.

Responsibilities

Analyze Aggregate Stop Loss Year End claims, High Level Review and Aggregate Accommodation claims.
Validate which expenses are eligible under the aggregate stop loss contract, identify and validate eligibility exceptions, extra-contractual claims and verify funding.
Perform enrollment evaluation and calculations to ensure the correct calculated or minimum attachment point is applied.
Produce deliverables related to audit findings, including Audit Report for client, Exhibits and Non Exhibits, within the Company accepted timeframes; and respond to all appeals from TPAs.
Contribute innovative ideas and assist with the implementation of new processes.