B

Brown & Brown Insurance

Provides risk management and insurance solutions

Aggregate Stop Loss Claims Auditor

Claims AdjudicationPosted on Nov 11
Full-timeRemote in USA$85k - $90k /yr

About the Job

Requirements

  • Must have proficiency in Excel, including knowledge of basic or advanced formulae and pivot tables.
  • Must have a minimum of 3–4 years of experience with self-funding plus specific and/or aggregate claims, or reinsurance claims.
  • Must demonstrate proficiency in Microsoft Office, including Microsoft Word and Outlook.
  • Must demonstrate analytical and critical-thinking skills.
  • Must demonstrate organizational and time-management skills and attention to detail.
  • Must have strong written and verbal communication skills.
  • Must be able to work independently with minimal supervision.

Responsibilities

  • Analyze aggregate stop loss year-end claims, high-level review claims, and aggregate accommodation claims.
  • Validate which expenses are eligible under the aggregate stop loss contract, identify and validate eligibility exceptions and 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 client audit reports, exhibits, and non-exhibits, within company-accepted timeframes, and respond to all appeals from third-party administrators.
  • Contribute innovative ideas and assist with implementing new processes.

Desired Qualifications

  • Prior experience with self-funding and the stop loss product.
  • Prior experience reviewing and/or auditing aggregate stop loss claims.
  • A history of successful process-improvement initiatives.

About the Company

Brown & Brown Insurance

Provides risk management and insurance solutions

Brown & Brown offers risk management and insurance solutions through Retail and Specialty Distribution. It acts as a broker and advisor, matching customers with coverage, assessing risk, and coordinating policies. The company differentiates itself with a large industry presence, a culture built on integrity and the Power of WE, and a strong commitment to local communities. Its goal is to help customers manage and reduce risk while protecting their assets over the long term.

Company size
5,001-10,000
Company stage
IPO
Headquarters
Leeds, United Kingdom
Founded
1914

Recently Posted Jobs

Explore more opportunities at Brown & Brown Insurance

See more jobs