Senior Claims Auditor

Job not on LinkedIn

🕒 July 29

❄️ Minnesota – Remote

❄️ Minnesota – Remote

💵 $56.6k - $125k / year

⏰ Full Time

🟠 Senior

🔎 Auditor

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 7%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Tokio Marine HCC

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

📦 Logistics

💼 Consulting

✈️ Travel

Logistics • Consulting • Travel

Tokio Marine HCC is a global specialty insurance and reinsurance group that underwrites more than 100 classes of specialty insurance across 180+ countries. The company offers a wide range of commercial products—including accident & health, aviation, casualty, cyber & tech, energy, marine, travel, crop, and transactional risk—serving brokers, enterprises, and program partners. With strong financial ratings (AM Best A++ / Fitch AA- / S&P A+) and a multi-billion dollar premium base, Tokio Marine HCC combines underwriting expertise, program management, and claims services as part of the Tokio Marine Group.

📋 Description

• Investigates claims liability and determines the extent of liability on a submitted claim for a specific individual • Accurately processes the claim according to the policies or contracts that exist, within the departmental time frames and standards, and establishes reserves for claim liability • Review and interpret employer plans of health coverage and excess insurance policy to individual claims • Audit submitted claim documents for sufficient data, verify that benefits were paid correctly and in accordance with appropriate plans and policies, and determine liability • Ability to complete claim review with minimal questions to supervisors • Able to communicate with external and internal customers in a professional and clear manner • Monitoring the weekly reserve report consistently • Monitoring the weekly pend report for timely follow up and accuracy • Determine, set, monitor reserves to maintain that reserves are appropriate • Authorize checks for amount of liability and communicate to Claims Administrator/client reasons for any amounts not covered by excess policy • Refer claims for cost containment to preliminary claims and specialty claims • Ability to audit complex claims and handle complex processes • Will be assigned more claims than an auditor, as needed

🎯 Requirements

• Strong medical knowledge including International Classification of Diseases (ICD), Current Procedural Terminology (CPT), medical terminology, COBRA, and HIPPA • Ability to read and interpret documents such as Plan of Benefits, claim reports, and procedural manuals • Possess and have ability to apply broad knowledge of principles, practices, and procedures • Excellent written and verbal communications skills with an emphasis on confidentiality, tact, and diplomacy • Exceptional organizational and analytical skills; demonstrated ability to manage multiple tasks simultaneously • Knowledgeable of industry changes, legal updates, and technical developments related to applicable area of the Company’s business to proactively respond to changing business environment • Intermediate proficiency and experience using Microsoft Office package (Excel, Access, PowerPoint, Word)

🏖️ Benefits

• Comprehensive medical, vision, and dental coverage, with eligibility beginning on your first day of employment • Basic life and disability insurance • 401(k) plan with 6% company match • 20 days of PTO, two floating holidays, approximately 11 paid holidays, and volunteer time off • Paid parental leave • Access to our award-winning wellness program, including mental health services, fitness network membership, and a complimentary Headspace subscription • Student loan matching program • Employee discount program