Senior Stop Loss Claims Auditor
Job Description:
• Conduct detailed audits of high-complexity claims files to ensure compliance, accuracy, and adherence to company procedures and regulatory requirements.
• 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.
Requirements:
• Bachelor's degree preferred; CPCU, AIC, or other insurance certifications a plus.
• 4 - 6 years of claims or audit experience (specific stop loss or first dollar medical).
• Strong understanding of claims handling and insurance regulations.
• Analytical, organized, and skilled in Excel/audit systems.
Benefits:
• medical
• dental
• vision
• disability
• life insurance
• retirement savings
• paid time off
• paid holidays
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