Funding Auditor

Relation Insurance Services • Tulsa, OK

2d

About The Position

The Funding Auditor supports the financial integrity of traditional self-funded and level-funded employer groups by validating funding activity, reconciling claim payments to expected funding, and partnering with internal teams to ensure accurate reporting and issue resolution. This individual in this role bridges the gap between reinsurance (stop-loss) and funding by reviewing claim activity that impacts stop-loss reporting and ensuring related funding records align to plan performance and contractual requirements.

Requirements

• High School diploma or equivalent required.
• Previous experience in health benefits administration, billing/funding, audit support, claims, or insurance operations.
• Strong attention to detail and ability to follow written procedures in a compliance-sensitive environment.
• Demonstrated ability to accurately and consistently enter data.
• Self-motivated with the ability to manage routine tasks independently.
• Intermediate computer proficiency, specifically with Microsoft Excel (filters, pivots), and the ability to learn new systems.

Nice To Haves

• Associate’s or Bachelor’s degree in Accounting, Finance, Business, Healthcare Administration, or related) preferred.
• Prior experience with reinsurance preferred.
• Familiarity with claim software systems is helpful.

Responsibilities

• Partners closely with the Stop-Loss team to obtain, review, and reconcile transaction detail, claim reimbursement reports, and payment files ensuring stop-loss recoveries are accurately reflected and aligned with underlying claims activity and plan terms.
• Coordinates and executes the timely transfer of funds from the reinsurance accounts to the appropriate employer or payor funding accounts, ensuring funds are moved in accordance with contractual requirements, internal controls and established funding deadlines.
• Accurately applies stop-loss and reinsurance proceeds to applicable claims and funding accounts, verifying proper allocation of claim, plan year, and funding source, while resolving discrepancies to ensure complete and accurate account balances.
• Prepares, reviews and submits stop-loss reimbursement and funding requests to employer groups and internal stakeholders, ensuring claims activity and funding levels are sufficient to support apaid and pending claims while maintaining required account thresholds.
• Conducts detailed account audits across multiple plan years, validating funding accuracy, claims payments, reimbursements, and transaction history, and ensuring all activity is properly documented and supported.
• Audits traditional self-funded accounts to confirm balances, funding transactions, and claims activity are accurate, complete, and compliant with plan terms, stop-loss agreements and internal audit standards.
• Leverages proprietary AI-enabled platforms to enhance accuracy, efficiency, and insight across funding, reinsurance, and audit activities.
• Performs other projects, duties, and tasks, as assigned.

Benefits

• Competitive pay.
• A safe and healthy work environment provided by our robust benefit program including family health and wellness programs, 401K, employee assistance programs, paid time off, paid holidays and more.
• Career advancement and development opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 251-500 employees