Stop Loss Claims Auditor

🔥 0 minutes ago

Apply Now
Find Similar Remote Jobs

📊 Check your resume score for this job

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

Logo of Risk Strategies Company

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

• 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 • Proficiency in Excel/audit systems

🏖️ Benefits

• Health Claims Stop Loss Claims Auditor conducts detailed audits of high-complexity claims files • Delivering comprehensive and customized insurance solutions

Apply Now

Similar Jobs

🔥 34 minutes ago

CLEAResult

1001 - 5000

⚡ Energy

📚 Education

Residential Energy Auditor at CLEAResult assisting residential customers with energy efficiency installations and audits. Building relationships with contractors and ensuring compliance with program standards.

🔥 38 minutes ago

BeOne Medicines

10,000+ employees

Internal Auditor supporting audits and advisory projects at BeOne, focusing on operational effectiveness and compliance. Collaborating with teams to enhance risk management and controls.

🔥 58 minutes ago

CACI International Inc

10,000+ employees

🔒 Cybersecurity

Senior Procurement Compliance Auditor ensuring compliance with CACI’s policies and federal regulations. Conducting procurement audits and collaborating with stakeholders to drive improvements.

🔥 15 hours ago

Medical Coding Auditor auditing medical records compliance for UNM Medical Group. Requires certifications and five years of experience in coding.

🔥 18 hours ago

Trend Health Partners

201 - 500

⚕️ Healthcare Insurance

💳 Fintech

🤖 Artificial Intelligence

Nurse Coder Auditor validating DRG assignments and medical necessity for healthcare claims. Collaborating with payers and providers to enhance healthcare access while reducing waste.

🇺🇸 United States – Remote

💵 $85k - $95k / year

💰 Private Equity Round on 2023-01

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor