Specific Stop Loss Claims Auditor
Risk Strategies
•$51,800 - $75,000•Remote
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 (specific stop loss or first dollar medical).
- Strong understanding of claims handling and insurance regulations.
- Proficiency 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.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
