Stop Loss Claims Auditor

Job Summary

Conducting detailed audits of high-complexity claims files, the full-time Stop Loss Claims Auditor will ensure compliance and accuracy while working remotely in the US.

Key responsibilities

• 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

Required qualifications

• 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