Senior Accident & Health Claims Leader

AXIS (AXIS Capital); Short Hills (NJ); Hybrid; USD 104,000 - 138,000; Full time

Benefits offered by this job

Competitive incentive compensation

Comprehensive benefits package

Paid time off

Job summary

AXIS (AXIS Capital) in Short Hills, New Jersey, is seeking an experienced Accident and Health Senior Claims Specialist. This role involves providing senior claims handling expertise across various product lines and supporting audits of Third-Party Administrators. Applicants should have 4-6 years of relevant experience and a Bachelor's degree.

The position includes a competitive salary ranging from $104K to $138K, along with comprehensive benefits such as medical, dental, vision plans, and tuition reimbursement.

Qualifications

• 4-6 years of experience with stop-loss, HMO managed care, excess provider programs including A&H products.
• Prior experience with MGU oversight, including Stop Loss, Provider Excess, and Managed Care claims.
• Knowledge of ERISA and applicable state claims handling requirements.

Responsibilities

• Conduct annual and desk audits of MGUs and TPAs.
• Monitor and enforce oversight procedures for MGUs and TPAs.
• Provide oversight of Provider Excess structures and HMO/Managed Care reimbursement.

Skills

Strong understanding of HMO, excess medical

Knowledge of medical cost containment

Strong Accident & Health claims management

Experience auditing and reviewing TPAs

Education

Bachelor’s degree or equivalent industry experience

Insurance designation preferred

Tools

Microsoft Office Suite

Power BI

Job description

AXIS (AXIS Capital) in Short Hills, New Jersey, is seeking an experienced Accident and Health Senior Claims Specialist. This role involves providing senior claims handling expertise across various product lines and supporting audits of Third-Party Administrators. Applicants should have 4-6 years of relevant experience and a Bachelor's degree.

The position includes a competitive salary ranging from $104K to $138K, along with comprehensive benefits such as medical, dental, vision plans, and tuition reimbursement.