Health Claims Stop Loss Auditor

Risk Strategies
$51,800 - $75,000Onsite

About The Position

The Health Claims Stop Loss Claims Auditor conducts detailed audits of high-complexity claims files to ensure compliance, accuracy, and adherence to company procedures and regulatory requirements.

Requirements

  • 4 - 6 years of claims or audit experience.
  • Strong understanding of claims handling and insurance regulations.
  • Analytical, organized, and skilled in Excel/audit systems.

Nice To Haves

  • Bachelor's degree preferred
  • CPCU, AIC, or other insurance certifications a plus.

Responsibilities

  • Perform in-depth claims file reviews for accuracy and compliance.
  • Document findings and provide recommendations for corrective action.
  • Identify trends and collaborate with departments to improve claim practices.
  • Support audit reporting and analytics.

Benefits

  • health_insurance
  • dental_insurance
  • vision_insurance
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