Brown & Brown
Posted 13 days agoVerified live 2d ago
Specific Stop Loss Claims Auditor
Brief overview
Remote
$75k–$90k/yrStated range
2 H-1B approvalsDept. of Labor
ExcelPivot TablesMedical Claims AuditingSpecific Stop Loss ClaimsAggregate Stop Loss ClaimsHMO ReinsuranceProvider Excess ClaimsPPO RepricingWrap NetworksReference-Based PricingMicrosoft OutlookProcess ImprovementWritten and Verbal Communication
About the company
Brown & Brownbbrown.com
Brown & Brown delivers risk management solutions to help protect and preserve what our customers value most.
Visa sponsorship history
2 years sponsoring, last filed FY2025
Data powered by U.S. Department of Labor. This does not guarantee sponsorship for this specific role.2H-1B approved
100%approval rate
1new H-1B hires
$92,160median wage / yr
H-1B Petition ApprovalsVisas USCIS actually granted: the strongest sign the company sponsors.
20252
LCA Certified ApplicationsAn early filing step, not a visa approval: it signals intent, not confirmed sponsorship.
20241
Top sponsored roles
Staff Accountant
Job description
Summary
Brown & Brown is an insurance services company seeking a Specific Stop Loss Claims Auditor to provide claims auditing services for managing general underwriters and carrier clients. The role analyzes and validates medical stop loss claims, applies policy calculations, supports clients, follows up on pended claims, and contributes to process improvements.
Responsibilities
- Analyze Specific Stop Loss claims
- Identify and isolate the data that is specific to a particular claim submission
- Validate which expenses are eligible under the stop loss policy and summary plan description
- Accurately apply all deductibles, coinsurances, aggregating specific deductibles and lasers
- Provide customer service for MGU partners and their respective TPAs
- Conduct timely follow up on all pended claims
- Contribute innovative ideas and assist with the implementation of new processes
Skills
- Must have Excel Proficiency to include knowledge of basic formulae, sorting techniques and PIVOT Tables
- Minimum 2 years Claims experience with first dollar medical claims, specific and/or aggregate claims, HMO reinsurance and/or provider excess claims
- Claims, HMO reinsurance and/or provider excess claims
- Prior experience with industry repricing methodologies. (PPO, Wrap Networks, Reference Based Pricing, etc.)
- Demonstrated proficiency in Microsoft Office, including Microsoft Outlook
- Demonstrated strong analytical/critical thinking skills; and detail‐oriented focus
- Strong written and verbal communication skills
- Ability to work independently with minimal supervision
- Prior experience auditing managed care or specific/aggregate stop loss claims
- History of successful Process Improvement initiatives
Qualifications
Must Haves
- Must have Excel Proficiency to include knowledge of basic formulae, sorting techniques and PIVOT Tables
- Minimum 2 years Claims experience with first dollar medical claims, specific and/or aggregate claims, HMO reinsurance and/or provider excess claims
- claims, HMO reinsurance and/or provider excess claims
- Prior experience with industry repricing methodologies. (PPO, Wrap Networks, Reference Based Pricing, etc.)
- Demonstrated proficiency in Microsoft Office, including Microsoft Outlook
- Demonstrated strong analytical/critical thinking skills; and detail‐oriented focus
- Strong written and verbal communication skills
- Ability to work independently with minimal supervision
Nice to Haves
- Prior experience auditing managed care or specific/aggregate stop loss claims
- History of successful Process Improvement initiatives
Benefits
- Medical/Rx
- Dental
- Vision
- Life Insurance
- Disability Insurance
- ESPP
- 401k
- Student Loan Assistance
- Tuition Reimbursement
- Free Mental Health & Enhanced Advocacy Services
- Paid Time Off
- Holidays
- Preferred Partner Discounts
