Remote Stop-Loss Claims Auditor: Validate & Optimize Claims
Imagine360, LLC
- Remote job
Imagine360, LLC is looking for a Stop Loss Claims Auditor to join their team in a fully remote capacity. This individual will work within the Stop Loss Department, ensuring claims are examined, audited, and processed accurately to support multiple functions. The ideal candidate should have an Associate or Bachelor's Degree, along with 3-5 years of medical claims processing experience. Strong communication and analytical skills are essential for success in this role, as well as a solid #J-18808-Ljbffr Imagine360, LLC
- Imagine360 is seeking a Stop Loss Claims Auditor to join the team! This position is part of the Stop... ...procedures. Position Location: 100% remote Responsibilities Demonstrate above average... .... Provide ongoing feedback to help optimize quality performance. Collaborate with...Remote workClaimsTemporary workWork at office
- ...all 50 states. We developed proprietary claims technology, expanded our offerings to include... ...We are seeking a Director of Claims & Stop-Loss Transformation to lead strategic... ...opportunities for workflow automation, TPA platform optimization, EDI improvements, and operational...Remote workClaimsContract workWork at office
$60k - $70k
Medical Stop Loss Underwriter - Remote! A growing and innovative organization in the healthcare insurance... ...completeness prior to quote release Validate underwriting data and ensure compliance... ...Analyze specific and aggregate claims experience and risk parameters Review...Remote jobClaimsImmediate start- Brown & Brown, Inc. is seeking a Health Claims Stop Loss Claims Auditor to conduct in-depth audits of high-complexity claims files for accuracy, compliance with procedures, and regulatory requirements. The role involves reviewing claims for accuracy, documenting findings...Claims
$100k
...for the Premium Auditor role at Brown & Joseph... ...audit and loss control prevention... ...schedule to maximize optimal use of time... ...customers and staff. Valid driver’s license... ...00.00 4 days ago REMOTE -Audit Senior - (... ...weeks ago Senior Claim Benefit Specialist - Stop Loss REMOTE -Audit...Remote workClaimsWeekly payFull timeLive inImmediate startWork from homeHome office2 days per week- Evolution Risk Partners, LLC is looking for a Stop Loss Claims Auditor or Senior Stop Loss Claims Auditor in Evanston, Illinois. The role involves auditing and authorizing reimbursements for medical claims while ensuring exceptional customer service. The ideal candidate...Claims
$53.9k
...ever-changing insurance market.The C&F Stop Loss Accounting department of the Accident &... ...position will interact internally with Claims, Policy, Digital Transformation, IT, Actuarial... ...premium bordereauxDaily bank reports to validate accuracy of deposits and paymentsMonthly...Remote workClaims- Stop Loss Claims Auditor or Senior Stop Loss Claims Auditor The Stop Loss Auditor is responsible for auditing and authorizing reimbursements of specific claims and effectively mitigate client medical stop loss claims and provide excellent customer service. Experience/...ClaimsContract workFlexible hours
$35 - $62.5 per hour
...Clinical DRG RN Auditor $10,000 SIGN ON BONUS FOR... ...help us advance health optimization on a global scale. Join... ...auditing of inpatient claims. Employing both... ...proprietary tools, you will validate ICD-10 diagnosis and procedure... ...independently in a remote environment and...Remote jobClaimsHourly payDaily paidMinimum wageFull timeTemporary workPart timeWork experience placementWork at officeLocal areaRelocation package$96.7k - $161.2k
...opportunity to join our team as a Manager, Stop Loss Claims!About the roleIn this role, you will... ...other leaders, to ensure compliance, optimize workflows, and position the team for future... ...our company.Please review Symetra's Remote Network Minimum Requirements:As a remote...Remote jobClaimsFull timeWork at officeImmediate startWork from homeFlexible hours$140k - $155k
Amwins in Seattle is seeking a Manager for Stop Loss Claims to oversee complex claims, applying expert judgment to enhance outcomes. This role involves mentoring claims professionals and collaborating with internal teams for effective claim adjudication. The ideal candidate...Remote jobClaims$107k - $140k
Sr. Manager, Stop Loss Claims Operations - Healthcare TPA Because health is personal. That's... ...across the enterprise. From reimbursement optimization to carrier negotiations to large-scale... ...This position offers flexibility for remote candidates. For candidates residing...Remote workClaimsContract workWork at office- Acrisure is seeking a Stop Loss Underwriter to evaluate, price, and manage risk for employer-sponsored self-funded health plans. This role... ...Underwriter collaborates with sales, clinical, policy, and claims teams to deliver sound underwriting decisions aligned with company...Remote jobClaims
- Acrisure is seeking a Stop Loss Underwriter to evaluate, price, and manage risk for employer-sponsored self-funded health plans. You will... ...competitive. Collaboration with sales, clinical, policy, and claims teams is essential to deliver sound underwriting decisions. The...Remote jobClaims
- Allied Benefit Systems, Inc. is seeking a Stop Loss Claims Specialist II to manage medical stop loss claims and ensure reimbursements from... ...communication skills, and proficiency in Microsoft Office. This fully remote position offers a competitive salary and generous benefits...Remote jobClaimsWork at office
- Prudential is seeking a Head of Stop Loss Claims to build and lead the claims organization within Medical Stop Loss operations. This remote role focuses on developing scalable workflows, driving innovation in claims processes, and delivering an exceptional experience for...Remote jobClaims
$67.9k
...tailored to needs in Employer Stop Loss, Excess Medical, Life, and... ...comorbid conditions to assess validity of data and clinical risk. Identify... ...for high-cost, complex claims through strategic identification... ...giving. #LI-JA1 #LI-Remote #J-18808-Ljbffr Crum & ForsterRemote workClaimsFlexible hours- Manager, Stop Loss Claims(Remote)Amwins Accident & Health Underwriters, formerly known as Beacon Risk Strategies, is conducting a search looking for an experienced Manager, Stop loss Claims.Amwins Accident & Health (Amwins A&H) has primary locations in Seattle, WA and Atlanta...Remote workClaimsContract workWork at office
$90k - $125k
...levels possible. Job Summary:The Senior Stop Loss Underwriter is responsible for evaluating... ...with sales, clinical, policy, and claims teams to deliver sound underwriting decisions... ...underwriting models and rating tools#LI-Remote#LI-SS1Pay Details:The base compensation range...Remote workClaimsFull timeContract workImmediate startFlexible hours- ...leaders to join our Group Insurance Medical Stop Loss (MSL) Distribution team. As a member of... ...., underwriting, commissions, contracts, claims, etc.).Coordinating Marketing, Sales, and... ...be willing to travel up to 50%This is a remote role.#LI-INWhat we offer you:Market competitive...Remote workClaimsFull timePart timeWork at office
- ...employee benefit brokers and consultants, stop loss carriers, and various clinical point... ...their financial interests. This is role is remote; however, it will require travel and in person... ...clinicians, underwriters, actuaries, and claims professionals, to develop comprehensive...Remote jobClaimsFull timeWork at officeWork from home
$70k - $80k
...activity associated with our stop loss accounts, providing support to... ...in the office; and 1 day remote where it makes sense to do so... ...execution. Broker liaison with BAH claim and finance departments.... ...files for claim adjudication. Auditor Liaison work with internal...Remote workClaimsFull timeWork at office$90k - $110k
...broad range of products, including employer stop loss, benefit captives, provider stop loss,... ...States. This position can either be fully remote (if not within commutable distance to the... ...of the Company’s clinical, actuarial, claims and distribution departments, all of which...Remote workClaimsFull timeWork at office- Cotiviti is seeking a Senior Auditor, Team Lead, to supervise a Clinical Validation auditing team. You will manage workflow, ensure quality outcomes, and drive... ...while training new hires. The role focuses on accurate claims auditing and client satisfaction. The position...Claims
$34.8k
...Claims Support Specialist Since 2000, Crum & Forster's Accident & Health division (A&... ...of products tailored to needs in Employer Stop Loss, Excess Medical, Life, and Ancillary and... ...located in the Phoenix metro area, but open to remote for the right candidate. We are hiring...Remote workClaimsWork at office$71.8k - $133.7k
...communities.BRIEF DESCRIPTIONThe Stop Loss Consultant role is tasked with supporting... ...on behalf of clients to secure optimal, cost-competitive benefit plans;Validate renewals and proposals for... ...MMA Agency;Help support Stop Loss claims tracking process;Help compile the...ClaimsMinimum wageWork experience placementLocal areaFlexible hours$68.2k - $102.3k
...management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We... ...Senior Manager, Stop Loss and Health Claims leads our dynamic claims unit. In this... ...settlement of complex claims, ensuring optimal balance between policyholder interests...ClaimsWork at officeLocal areaFlexible hours- UnitedHealth Group is seeking a Clinical DRG RN auditor to apply expert MS-DRG/APR-DRG coding knowledge and ICD-10 guidelines in inpatient claims audits. This remote role allows telecommuting from anywhere in the U.S. with a sign-on bonus for external applicants. Responsibilities...Remote jobClaimsRelocation package
$65k - $73k
...CAREER AT SLEQ SOLUTIONS SLEQ is looking for a Stop Loss Accountant to join our shared services team.... ...and compare aggregate funding to claim payments; research and clear variances. Claims cash: Process/validate ACH requests for claim funding and related cash...ClaimsFull timeWork at office$70k - $80k
...inpatient care and a passion for getting the details right? Join EXL as a Clinical Validation Auditor and help ensure medical claims are coded accurately and fairly. This is a fully remote position where you’ll use your clinical judgment to review medical records,...Remote workClaimsFull time
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