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Specific Stop Loss Claims Auditor

Role overview

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

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

Key facts

Other skills

  • Microsoft Excel
  • Problem Solving
  • Collaboration

About the company

Risk Strategies Company logo

Risk Strategies Company

Insurance Brokerage & Agencies

At Risk Strategies, we help our clients protect those things that matter most to them. We help them see the way forward in a complex world with specialty insight, practical advice, and custom insurance with a vast network of specialists in Property & Casualty, Employee Benefits, Private Client, as well as Consulting Services and Financial and Wealth Management solutions. We are a different kind of insurance brokerage – bringing a strategic, holistic, specialist approach to our clients, so they can face the future with confidence. We are the 9th largest privately held insurance broker in the US with over 30 specialty practices, 150+ locations, and 5,000 team members (and counting!). We love what we do, and it shows. We’ve been recognized as a 'best place to work' for many years running, and we’re excited about our future. Risk Strategies is an Accession Risk Management Group company, a family of specialty insurance distribution and risk management companies powered by a shared vision of delivering a superior client and employee experience.

Company details

Company typeXLarge
IndustryInsurance Brokerage & Agencies
Company size5001 - 10000

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Job description

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

Your Impact

  • 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.

Successful Candidate Will Have

  • 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.

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, innovative strategies for our customers at every step of their growth journey. Learn more at BBrown.com.

Pay Range:

$51,800 - $75,000 Annual

The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for this role.

Brown & Brown, Inc. and our team of companies is an equal opportunity workplace and is committed to ensuring equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, Veteran status, or other legally protected characteristics. Learn more about working at Risk Strategies, part of the Brown & Brown team, by visiting https://us.bbrown.com/careers/.  

Personal information submitted by California applicants in response to a job posting is subject to Risk Strategies' California Job Applicant Privacy Notice.


Recruiting Vendor Disclosure Statement

Brown & Brown does not accept unsolicited resumes from external recruiters, recruitment vendors or employment agencies (“Recruiting Vendors”). Recruiting Vendors must have a valid written agreement and receive prior written authorization from an authorized Brown & Brown representative before submitting candidates for any publicly posted role.  Any unsolicited resumes submitted to Brown & Brown or its employees become the property of Brown & Brown, and no fees will be paid for such submissions.  Additional information regarding this policy can be found on our careers page.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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