Aggregate Claims Auditor
At a glance
Mid-level role at Bb Insurance. Remote, United States · full-time · $85,000–$90,000 base.
remoteroles summary, based on the employer's posting.
What you'll do
- Review year-end aggregate stop loss, high-level review, and aggregate accommodation claims
- Check contract terms against expenses, flag eligibility exceptions and extra-contractual claims, and confirm funding
- Evaluate enrollment and calculate the attachment point that should apply
- Prepare client audit reports and supporting exhibits on schedule, then address TPA appeals
- Suggest process changes and help put new procedures into practice
What you bring
- At least three to four years handling self-funded claims, specific or aggregate claims, or reinsurance claims
- You can use Excel formulas and pivot tables, along with Word and Outlook
- You bring strong analytical judgment, careful organization, time management, and clear communication
- You can manage your work with little supervision
Who this fits
This remote U.S. role suits someone with claims auditing experience who can work independently and meet delivery timelines. Occasional travel may be required.
From the employer
Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers.
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.
- Prior experience with self-funding and the stop loss product. (preferred)
- Prior experience reviewing and/or auditing aggregate stop loss claims. (preferred)
- History of successful Process Improvement initiatives. (preferred)
Pay Range
$85,000 - $90,000 AnnualThe 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.
Recruiting Vendor Disclosure Statement
Brown & Brown does not accept unsolicited resumes from external recruiters, recruitment vendors or employment agencies ("Recruiting Vendors"). Recruiting Vendors must have a valid written agreement and received prior written authorization from an authorized Brown & Brown representative before submitting candidates for any publicly posted role. Any unsolicited resumes submitted to Brown & Brown or its employees become the property of Brown & Brown, and no fees will be paid for such submissions. Additional information regarding this policy can be found on our careers page.
The Power To Be Yourself
As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, “The Power to Be Yourself”.