Aggregate Stop Loss Claims Auditor

Brown & Brown, Inc.

$75K — $90K *
US-AnywhereRemote in United States
Finance & Insurance
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Excel proficiency including advanced formulas and PIVOT tables.
  • 3-4 years of experience with self-funding or reinsurance claims.
  • Proficient in Microsoft Office, including Word and Outlook.
  • Strong analytical and critical thinking skills.
  • Excellent organizational and time management skills.
  • Detail-oriented with strong written and verbal communication skills.
  • Ability to work independently with minimal supervision.

Responsibilities

  • Analyze Aggregate Stop Loss Year End claims and related documents.
  • Validate eligible expenses under aggregate stop loss contracts.
  • Perform enrollment evaluation to ensure accuracy of attachment points.
  • Produce audit-related deliverables, including reports and exhibits.
  • Respond to appeals from third-party administrators (TPAs).
  • Contribute innovative ideas for process improvements.

Benefits

  • Comprehensive health benefits including medical, dental, vision, and life insurance.
  • Financial benefits such as ESPP, 401k, and tuition reimbursement.
  • Mental health and wellness services, including advocacy support.
  • Generous paid time off, holidays, and partnership discounts.
Full Job Description
Brown & Brown is seeking an Aggregate Stop Loss Claims Auditor to join our growing team!

How You Will Contribute:

  • Analyze Aggregate Stop Loss Year End claims, High Level Review and Aggregate Accommodation claims.
  • Validate which expenses are eligible under the aggregate stop loss contract, identify and validate eligibility exceptions, extra-contractual claims and verify funding.
  • Perform enrollment evaluation and calculations to ensure the correct calculated or minimum attachment point is applied.
  • Produce deliverables related to audit findings, including Audit Report for client, Exhibits and Non Exhibits, within the Company accepted timeframes; and respond to all appeals from TPAs.
  • Contribute innovative ideas and assist with the implementation of new processes.


Skills & Experience to be Successful:

  • Must have Excel Proficiency to include knowledge of Basic or Advanced Formulae and PIVOT Tables.
  • Minimum 3-4 years of experience with self-funding plus specific and/or aggregate claims; or reinsurance claims.
  • Demonstrated proficiency in Microsoft Office, to include Microsoft Word and Outlook.
  • Demonstrated strong analytical/critical thinking skills.
  • Demonstrated organizational skills, time management skills and detail-oriented focus.
  • Strong written and verbal communication skills.
  • Ability to work independently with minimal supervision.
  • Occasional travel may be needed.


Preferred:

  • Prior experience with self-funding and the stop loss product.
  • Prior experience reviewing and/or auditing aggregate stop loss claims.
  • History of successful Process Improvement initiatives.


Pay Range
$75,000 - $90,000 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 the role.

Teammate Benefits & Total Well-Being

We go beyond standard benefits, focusing on the total well-being of our teammates, including:
  • Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance
  • Financial Benefits: ESPP; 401k; Student Loan Assistance; Tuition Reimbursement
  • Mental Health & Wellness: Free Mental Health & Enhanced Advocacy Services
  • Beyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts and more.


Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations.

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