Senior Stop-Loss Claims Auditor | Compliance & Analytics

Risk Strategies Company; United States; On-site; USD 80,000 - 110,000; Full time

Job summary

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

(NYSE: BRO) is a leading insurance brokerage firm delivering comprehensive and customized insurance solutions and specialization since 1939. With a global presence spanning 700+ locations and a team of approximately 23,000 professionals, we are dedicated to delivering scalable,

Qualifications

• Bachelor's degree (preferred); CPCU, AIC, or other insurance certifications a plus.
• 4 - 6 years of claims or audit experience (specific stop loss or first dollar medical).
• Strong understanding of claims handling and insurance regulations.
• Proficiency in Excel/audit systems.

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.

Skills

Excel proficiency

Audit systems

Claims handling

Education

Bachelor's degree (preferred)

CPCU/AIC a plus

Tools

Audit software

Job description

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

(NYSE: BRO) is a leading insurance brokerage firm delivering comprehensive and customized insurance solutions and specialization since 1939. With a global presence spanning 700+ locations and a team of approximately 23,000 professionals, we are dedicated to delivering scalable,