Claims Examiner – Medical Stop Loss

🔥 0 minutes ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $48.3k - $90.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

👻 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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Crum & Forster

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🛡️ Insurance

⚕️ Healthcare Insurance

Insurance • Healthcare Insurance

Crum & Forster (C&F) is a leading national property & casualty insurance company with a large, diversified specialty platform. Established in 1822, C&F provides specialty and standard commercial lines insurance products through its admitted and surplus lines insurance companies. With a written premium of $5. 3 billion as of 2023, C&F has an A. M. Best financial strength rating of “A” (Excellent). The company prides itself on creative, flexible, and client-focused solutions, recognized for superior customer service, claims, and risk engineering services. C&F employs over 2000 people across the United States and has earned several workplace awards for its employee-first focus and commitment to diversity, equity, and inclusion. C&F is part of Fairfax Financial Holdings Limited, engaged in property and casualty insurance and reinsurance.

📋 Description

• Review all claim submissions for accuracy, completeness, and compliance with Plan Documents, SPDs, and Policies within documented authority levels • Communicate external requests for information and maintain timely follow-up • Communicate claim payment and denial decisions • Confirm appropriate disclosure when applicable • Calculate and maintain reserves as needed • Assist with aggregate accommodation activities and aggregate claim submissions • Maintain reporting and communication with team and management regarding assigned responsibilities • Assist with refining internal claim procedures and recommending improvements to management • Perform other duties as assigned

🎯 Requirements

• 3+ years medical stop loss claim experience required • Bachelor’s degree or equivalent experience required • Strong working knowledge of Microsoft Office suite • Aptitude to learn new programs • Ability to establish a good rapport with all stakeholders • Commitment to delivering outstanding customer service and satisfaction • Commitment to exploring and assisting in implementing new processes to increase effectiveness and achieve organizational goals • Exceptional attention to detail and accuracy • Capability to manage multiple priorities in a fast-paced environment • Excellent written and verbal communication skills

🏖️ Benefits

• Competitive compensation package • Generous 401K employer match • Employee Stock Purchase plan with employer matching • Generous Paid Time Off • Health, dental and vision benefits • Wellness programs focused on physical, mental and financial wellbeing • Tuition reimbursement • Industry-related certifications • Professional training • Dynamic, ambitious, fun and exciting work environment • Matching donation program • Volunteer opportunities • Employee-driven corporate giving program