Aggregate Stop Loss Claims Auditor

Brown & Brown; United States; Remote; USD 75,000 - 90,000; Full time

Benefits offered by this job

Health benefits – Medical/Rx, Dental,

Vision, Life Insurance

401k

Student loan assistance

Tuition reimbursement

Paid time off

Mental health services

Job summary

Brown & Brown is seeking an Aggregate Stop Loss Claims Auditor to join our growing team. You will analyze year-end aggregate stop loss claims and perform high-level reviews to validate eligible expenses under the stop loss contract.

Ideal candidates have 3-4 years of self-funding or reinsurance claims experience, strong Excel skills (formulas and Pivot Tables), and excellent written and verbal communication. Travel may be required as part of the role.

Qualifications

• Minimum 3-4 years of experience with self-funding plus aggregate claims or reinsurance claims.
• Proficiency in Microsoft Office, including Word and Outlook.
• Strong analytical, critical thinking and problem-solving abilities.
• Excellent written and verbal communication skills; detail-oriented and organized.
• Ability to work independently with minimal supervision; occasional travel may be required.

Responsibilities

• Analyze Aggregate Stop Loss Year End claims, High Level Review and Aggregate Accommodation claims.
• Validate eligible expenses under the aggregate stop loss contract, identify eligibility exceptions and extra-contractual claims; verify funding.
• Perform enrollment evaluation and calculations to ensure correct attachment points are applied.
• Produce Audit Reports and Exhibits; respond to all appeals from TPAs within company timeframes.
• Contribute innovative ideas and assist with new process implementations.

Skills

Excel Proficiency

Self-funding Claims

MS Office

Analytical Thinking

Attention to Detail

Communication Skills

Independent Work

Travel Optional

Tools

Microsoft Word

Outlook

Job description

Rmote

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers.

Brown & Brown is seeking an Aggregate Stop Loss Claims Auditor to join our growing team!

How You Will Contribute:

• Analyze Aggregate Stop Loss Year End claims, High Level Review and Aggregate Accommodation claims.
• Validate which expenses are eligible under the aggregate stop loss contract, identify and validate eligibility exceptions, extra-contractual claims and verify funding.
• Perform enrollment evaluation and calculations to ensure the correct calculated or minimum attachment point is applied.
• Produce deliverables related to audit findings, including Audit Report for client, Exhibits and Non Exhibits, within the Company accepted timeframes; and respond to all appeals from TPAs.
• Contribute innovative ideas and assist with the implementation of new processes.

Skills & Experience to be Successful:

• Must have Excel Proficiency to include knowledge of Basic or Advanced Formulae and PIVOT Tables.
• Minimum 3-4 years of experience with self-funding plus specific and/or aggregate claims; or reinsurance claims.
• Demonstrated proficiency in Microsoft Office, to include Microsoft Word and Outlook.
• Demonstrated strong analytical/critical thinking skills.
• Demonstrated organizational skills, time management skills and detail‐oriented focus.
• Strong written and verbal communication skills.
• Ability to work independently with minimal supervision.
• Occasional travel may be needed.

Preferred:

• Prior experience with self-funding and the stop loss product.
• Prior experience reviewing and/or auditing aggregate stop loss claims.
• History of successful Process Improvement initiatives.

Pay Range

$75,000 - $90,000 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 the role.

Teammate Benefits & Total Well-Being

• Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance
• Financial Benefits: ESPP; 401k; Student Loan Assistance; Tuition Reimbursement
• Mental Health & Wellness: Free Mental Health & Enhanced Advocacy Services
• Beyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts and more.

Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations.