Health Claims Stop Loss Auditor

Risk Strategies Company

Health Claims Stop Loss Auditor conducting detailed audits of insurance claims files for compliance and accuracy. Collaborating with departments to improve practices and support audit reporting.

Posted 6/24/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $51,800 - $75,000 per yearWebsite

About the role

Key responsibilities & impact

Conducts detailed audits of high-complexity claims files to ensure compliance, accuracy, and adherence to company procedures and regulatory requirements.
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.

Requirements

What you’ll need

Bachelor's degree preferred; CPCU, AIC, or other insurance certifications a plus.
4 - 6 years of claims or audit experience.
Strong understanding of claims handling and insurance regulations.
Analytical, organized, and skilled in Excel/audit systems.

Benefits

Comp & perks

Health Claims Stop Loss
Flexible work arrangements
Professional development opportunities
Equal opportunity workplace

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

claims auditingclaims file reviewcompliance analysisdata analysisExcelaudit systems

Soft Skills

analytical skillsorganizational skillscollaboration

Certifications

Bachelor's degreeCPCUAIC