Remote Medical Stop-Loss Claims Examiner

Crum & Forster; Scottsdale (AZ); Remote; USD 48,000 - 91,000; Full time

Benefits offered by this job

Competitive compensation

401K employer match

Employee Stock Purchase plan

Generous Paid Time Off

Tuition reimbursement

Professional training opportunities

Social and community responsibility

Job summary

Crum & Forster is seeking a claims professional to support its Accident & Health division's medical stop loss line. The role involves evaluating eligibility, processing payments, and maintaining reporting with teammates and partners. The candidate works within documented authority and collaborates to strengthen underwriting support.

The position emphasizes accuracy, stakeholder communication, and efficient handling of high-priority claims in a large, stable organization.

Qualifications

• 3+ years medical stop loss claim experience required.
• Bachelor’s degree or equivalent experience required.
• Strong communication skills (written and verbal).
• Excellent attention to detail and accuracy.
• Ability to manage multiple priorities in a fast-paced environment.

Responsibilities

• Review claim submissions within authority levels for accuracy and compliance.
• Communicate external information requests clearly and follow up in a timely manner.
• Communicate claim payment and denial decisions professionally.
• Maintain disclosure when applicable and calculate reserves as needed.
• Assist with aggregate accommodation activities and reporting to management.
• Refine internal claim procedures and propose improvements to leadership.
• Perform other duties as assigned.

Skills

Medical stop loss experience

Communication skills

Attention to detail

Multitasking

Stakeholder management

Customer service

Education

Bachelor’s degree

Tools

Microsoft Office

Job description

Crum & Forster is seeking a claims professional to support its Accident & Health division's medical stop loss line. The role involves evaluating eligibility, processing payments, and maintaining reporting with teammates and partners. The candidate works within documented authority and collaborates to strengthen underwriting support.

The position emphasizes accuracy, stakeholder communication, and efficient handling of high-priority claims in a large, stable organization.