Stop Loss Claims Auditor

Job not on LinkedIn

🔥 13 hours ago

🇺🇸 United States – Remote

💵 $75k - $90k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔎 Auditor

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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.

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Brown & Brown Insurance

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1939

💸 Finance

🛡️ Insurance

Finance • Insurance

Brown & Brown Insurance is one of the largest independent insurance brokerages globally, providing a comprehensive range of risk management solutions. Established in 1939, the company offers personal and business insurance, employee benefits, and various national programs. Brown & Brown is committed to diversity, inclusion, and belonging, fostering a culture that values talent and experience. With over 500 locations, the company is well-positioned to meet the diverse needs of its clientele and is listed on the New York Stock Exchange under the ticker BRO. The firm's strategic focus on mergers and acquisitions highlights its disciplined growth strategy.

📋 Description

• Analyze Specific Stop Loss claims • Identify and isolate data specific to a particular claim submission • Validate which expenses are eligible under the stop loss policy and summary plan description • Accurately apply deductibles, coinsurances, aggregating specific deductibles and lasers • Provide customer service for MGU partners and their respective TPAs • Conduct timely follow-up on all pended claims • Contribute innovative ideas and assist with implementation of new processes

🎯 Requirements

• Must have Excel proficiency, including knowledge of basic formulae, sorting techniques and Pivot Tables • Minimum 2 years claims experience with first dollar medical claims, specific and/or aggregate claims, HMO reinsurance and/or provider excess claims • Prior experience with industry repricing methodologies (PPO, Wrap Networks, Reference Based Pricing, etc.) • Demonstrated proficiency in Microsoft Office, including Microsoft Outlook • Demonstrated strong analytical/critical thinking skills and detail-oriented focus • Strong written and verbal communication skills • Ability to work independently with minimal supervision • Preferred: Prior experience auditing managed care or specific/aggregate stop loss claims • Preferred: History of successful Process Improvement initiatives

🏖️ Benefits

• Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance • Financial Benefits: ESPP; 401k; Student Loan Assistance; Tuition Reimbursement • Mental Health & Wellness: Free Mental Health & Enhanced Advocacy Services • Paid Time Off • Holidays • Preferred Partner Discounts