Health Claims Stop Loss Auditor

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.
• Support audit reporting and analytics.
• Successful Candidate Will Have
• 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.
• Pay Range:
• $51,800 - $75,000 Annual
• The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for this role.
• Personal information submitted by California applicants in response to a job posting is subject to Risk Strategies' California Job Applicant Privacy Notice .
• Recruiting Vendor Disclosure Statement

Benefits

Additional Information

The Health Claims Stop Loss Claims Auditor conducts detailed audits of high-complexity claims files to ensure compliance, accuracy, and adherence to company procedures and regulatory requirements.

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Company Intel

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