Senior Stop Loss Claim Auditor

Job Summary

Senior Stop Loss Claim Auditor, a full-time remote position responsible for auditing and authorizing reimbursement of medical stop loss claims while providing excellent customer service.

Key Responsibilities

• Analyze and adjudicate stop loss claims and authorize reimbursement checks
• Initiate claims investigations, interpret plan language, and identify follow-up needs
• Communicate with carriers, vendors, and management, and maintain claims system reports

Required Qualifications

• Associate's degree
• 6 years of managed care or reinsurance claims experience
• Experience analyzing laws, regulations, and contract language
• Ability to handle confidential and sensitive information
• Experience with aggregate claims