Health Claims Stop Loss Auditor

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Risk Strategies Company

5001 - 10000 employees

🏢 Enterprise

💸 Finance

Enterprise • Finance • Insurance

Risk Strategies Company is a comprehensive insurance brokerage and risk management firm. It offers a wide range of services including commercial insurance, employee benefits, private client insurance, and specialty risk management solutions tailored to the unique needs of businesses and individuals. With expertise across diverse industries, Risk Strategies provides innovative and customized solutions to mitigate risks and optimize coverage. Their client-centric approach ensures personalized service and dedicated support, making them a trusted partner in managing risk and developing resilience.

📋 Description

• Conducts 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. • Strong understanding of claims handling and insurance regulations. • Analytical, organized, and skilled in Excel/audit systems.

🏖️ Benefits

• Health Claims Stop Loss • Flexible work arrangements • Professional development opportunities • Equal opportunity workplace

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