Health Claims Stop-Loss Audit Specialist
RSC Insurance Brokerage, Inc.
RSC Insurance Brokerage, Inc. is seeking a Health Claims Stop Loss Claims Auditor responsible for conducting detailed audits of high-complexity claims files to ensure compliance and accuracy. You will perform in-depth claims reviews, document findings, and collaborate with departments to enhance claim practices. The ideal candidate has a Bachelor's degree, 4–6 years of claims or audit experience, and strong analytical skills. #J-18808-Ljbffr RSC Insurance Brokerage, Inc.
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Health Claims Stop-Loss Audit Specialist in New York, NY vacancy
- A global fintech leader is seeking a Stop Loss Underwriter to evaluate, price, and manage risk for self-funded health plans. The role requires collaboration with sales, clinical, policy, and claims teams to ensure profitable underwriting. Candidates should have 2+ years...Claims
$23.16 - $35.88 per hour
A major healthcare provider is seeking a Stop Loss Claims Analyst who will review, evaluate, and process claims. This role involves building... ...must have at least 5 years of relevant experience in health insurance claims, with strong organizational and problem-solving...ClaimsHourly payWork at office$23.16 per hour
...evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround... ...request is accurate by auditing the claim for duplicate line-item... ...relevant, progressive experience in health insurance claims 3 years of prior...ClaimsWork at officeLocal area- ...locations will be considered. Job Summary The Stop Loss Underwriter is responsible for evaluating... ...risk for employer‑sponsored self‑funded health plans. This role includes underwriting... ...with sales, clinical, policy, and claims teams to deliver sound underwriting decisions...ClaimsContract workImmediate startFlexible hours
$115k - $145k
Job Overview The Senior Safety Loss Control Consultant is responsible for providing risk management, loss prevention, and safety related... ...needs, and industry best practices. Work closely with the claims team and analytics group to review large losses, analyze loss trends...Claims- ...united in the drive to transform employee health benefits. The company was founded in 2011... ...lead the evolution of our captive-based stop‑loss solutions and drive innovation across our... ...associated opportunities through broker feedback, claims analysis, regulatory insights, and...ClaimsFor subcontractorFlexible hours
Dormont Manufacturing Company
New York, NY3 days ago - Charles Taylor is seeking a Loss Adjuster in the United States to undertake detailed investigations regarding insurance claims. You will assess the legitimacy of claims, negotiate settlements, and communicate with various stakeholders. The ideal candidate will have 2-5...Claims
$130k - $170k
AON PLC is seeking a Property Claim Consultant specializing in complex property and construction losses. This senior-level role involves advising clients on large commercial property insurance claims, leading the claim preparation process, and providing strategic guidance...ClaimsRemote job$130k - $170k
Aon Corporation is seeking a Property Claim Consultant for a senior-level role involving complex property insurance claims. This position... ...and lead the analysis of property damage and construction losses. A Bachelor's degree and 7-10 years of relevant experience are essential...ClaimsRemote work$130k - $170k
Aon is seeking a Property Claim Consultant in New Jersey to provide senior-level advisory services for complex commercial property insurance... ...leading claim preparation efforts, strategic guidance on loss quantification, and direct client interaction. Candidates should...ClaimsRemote job- Ryan Specialty, LLC is seeking a Contract Loss Adjuster to play a critical role in our claims operations. The ideal candidate will conduct field inspections, evaluate crop damage, and ensure compliance with MPCI program guidelines. Responsibilities include collecting data...ClaimsContract work
$90k - $120k
...platform and a global network of specialists spanning 40 countries.... ...payment of related invoices. Claims management, including the investigation... ...with potential exposure for loss to ensure maintenance of... ...information, reproductive health decision, sexual orientation,...ClaimsContract workLocal areaSotheby's
New York, NY1 day ago- Job Title: Life Science & Digital Health Claims Manager Division: Group Claims Location: United... .... Handle claims from first notice of loss through resolution, assessing severity,... ...delegated partners. Conduct file reviews or audits as required, and resolve any issues...ClaimsImmediate start
$120k - $150k
...summarizing, analyzing, presenting and monitoring safety events, claims management, loss prevention and reduction, patient safety related quality... ...the day to day risk management activities the Mount Sinai Health System (MSHS). The Clinical Risk Manager conducts...ClaimsTraineeshipLocal areaFlexible hoursShift workMount Sinai Hospital
Brooklyn, NY1 day ago$61.3k - $103.5k
...while providing detailed accounting and claims information to support sales. Strong relationships... ...At least 2 years of experience in excess‑loss reinsurance and accounting, plus a... ...500, plus performance‑based incentives. Health and welfare benefits, tuition assistance,...ClaimsWork at officeFlexible hours3 days per week$160k - $180k
...Property & Casualty and Accident & Health insurance and reinsurance... ...profit improvement and combined loss ratio results. Partnering... ...including Finance, Actuarial, Claims, Legal, Compliance, Operations... ...submissions and approvals. Performing audits and conducting program reviews...ClaimsRemote jobTemporary workVisa sponsorshipWork visa$21.2 - $34.69 per hour
...offer home, auto and accident and health insurance, as well as other... ...and confirming the facts of loss for advanced automobile accidents... ...adjusts and negotiates claims within limit of authority. Candidates... ...(Coverage, Investigation Specialist, Total Loss, Initial Handler,...ClaimsWork at officeLocal areaRemote workWork from homeVisa sponsorshipWork visaDormont Manufacturing Company
New York, NY15 hours ago- Position Summary Position Summary: The Contract Loss Adjuster plays a critical role in AgCentric’s claims operations by conducting field inspections, evaluating... ...sick and personal days, paid parental leave, mental health services, and more. Additional information about...ClaimsContract work
$90k - $100k
...OPPORTUNITY IS FOR YOU... Stop chasing a job and start... ...their most difficult loss of independence. The revolution... ...personal trainers who claim to be strength and conditioning specialists working with injuries and... ...surgical musculoskeletal health and regenerative medicine...ClaimsFull timeTemporary workPrivate practiceImmediate startRelocation packageAllcare PT
Brooklyn, NY3 days ago$120k - $150k
...Overview Company Overview: Essen Health Care is a growing community healthcare network that... ...and monitor risk scores, PMPM trends, stop‑loss exposure, Databricks, SQL, Python. Support... ...experience with Power BI. Strong knowledge of claims data, CMS methodologies, and medical cost...ClaimsEssen Medical Associates
New York, NY4 days ago- ...The Assistant Director of Group Health is responsible for the overall... ...internal and external quality audits and make recommendations on... ...Responsible for the overall Profit and Loss of the Group Health Division... ...over 200,000 insurance claims annually for leading national...ClaimsTemporary workRemote workWork from home
- Arlo is rebuilding health insurance from the ground up using AI. The healthcare experience... ...Development Lead to own and grow our MGU stop‑loss business with health plan and TPA... ...resolution of service, billing, eligibility, claims, and TPA‑related issues Coordinate across...Claims
$275k - $325k
...oversight) Reports to: Global Head of Claims Direct Reports: 10+ (with... ...Insurance, Global Accident & Health, and Global Reinsurance. Key... ...reporting, litigation tracking, and audit compliance. Operational... ...business units. Oversee large loss tracking, financial reporting,...ClaimsFull timeRemote work- ...patient safety, quality of care, and minimize loss to protect the assets of the facility.... ..., the New York State Department of Health and other accrediting agencies. This individual... ...Investigators: reporting potential claims as well as cases of concern by preparation...ClaimsFull timeTraineeshipWork at officeLocal areaShift work
- ...Collision Repair Expert to join its Western Claims Service Center team. As a CRE, you’re... ...Evaluate and determine repairable vs total loss vehicles Respond to CAT losses in other... ...insurance, personal accident and supplemental health insurance, reinsurance, and life...ClaimsFull timeTemporary workLocal area
- ...experienced billing professionals 5 + years to join our remote team. What we’re looking for: Experience in dental insurance billing, claim submission, and payment posting Strong knowledge of dental insurance plans, EOBs, and appeal processes Ability to manage insurance...ClaimsRemote workWork from home
Dental Business Office
New York, NY2 days ago - ## Delegated Claims Audit Specialist - General LIability/Auto/PropertyApplyremote type: Hybridlocations: GA-Atlanta: IL-Chicagotime type: Full timeposted... ...policy provisions, and industry best practices, supporting loss-cost control and TPA performance management.**Key...ClaimsWork at office
- AXA XL is hiring a Claims Specialist in New York, NY to evaluate and handle complex insurance claims within the Property division. The specialist will manage the resolution of claims while collaborating closely with insurance teams and external stakeholders. The ideal candidate...Claims
$130k - $190k
...so they can thrive in their health and wealth. Powered by AI and... ...looking for a Benefits Product Specialist to sit at the intersection of... ...ranging from "how does stop‑loss work" to "what does a TPA actually... ...and aggregate), underwriting, claims data, plan design, COBRA, FSA...ClaimsWork at office$135k - $145k
...WeightWatchers is a global digital health company and the world's... ...for members on weight-loss medications, and... ...GIFs/video) and how to stop the scroll. ~... ...when collaborating with specialists (photographers, illustrators... ...contacted by someone claiming to represent WeightWatchers...ClaimsWorldwideWW International, Inc. (Weight Watchers)
New York, NY3 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Health Claims Stop-Loss Audit Specialist. Be the first to apply!
Related searches
- claims specialist remote New York, NY
- claims consultant New York, NY
- insurance claims processor New York, NY
- life insurance claim analyst New York, NY
- medical claims analyst New York, NY
- claim specialist New York, NY
- remote medical claims processor New York, NY
- claims analyst New York, NY
- claims resolution specialist New York, NY
- claim representative (remote) New York, NY