Remote Specific Stop-Loss Claims Auditor

Brown & Brown, Inc.; Northern (KY); Hybrid; USD 75,000 - 90,000; Full time

Benefits offered by this job

Health benefits

401(k)

Tuition reimbursement

Paid time off

Job summary

Brown & Brown, Inc. is seeking a Specific Stop Loss Claims Auditor to join our remote USA team. The role focuses on auditing Specific Stop Loss claims for MGUs and Carriers, applying policy terms accurately and providing strong data-driven insights.

The candidate will analyze claims, validate eligible expenses, and support clients with efficient, compliant processing and improvements to existing procedures.

Qualifications

• 2+ years claims experience, focusing on Specific Stop Loss and related reinsurance contexts.
• Proficient in data analysis, data extraction, and identifying claim-specific data points.
• Strong ability to apply deductibles, coinsurance, and policy terms to individual claims.

Responsibilities

• Analyze Specific Stop Loss claims and identify claim-specific data.
• Validate eligible expenses under stop loss policy and SPD.
• Apply deductibles, coinsurance, and lasers to claims.
• Provide customer service to MGU partners and TPAs.
• Follow up on pended claims and support process improvements.

Skills

Excel proficiency

Claims experience

Analytical thinking

Communication skills

Independent work

Tools

Excel

Pivot Tables

Microsoft Office

Job description

Brown & Brown, Inc. is seeking a Specific Stop Loss Claims Auditor to join our remote USA team. The role focuses on auditing Specific Stop Loss claims for MGUs and Carriers, applying policy terms accurately and providing strong data-driven insights.

The candidate will analyze claims, validate eligible expenses, and support clients with efficient, compliant processing and improvements to existing procedures.