Claims Auditor-Self Funded Benefits

About the position

NFP, an Aon Company, is a multi-year Best Places to Work award winner in Business Insurance who has also earned the WORK180 employer endorsement. We are an organization of consultative advisors and problem solvers. We help companies and individuals around the globe address their most significant risk, workforce, wealth management and retirement challenges through custom solutions and a people-first approach. We are seeking a detail-oriented and analytical Stop Loss Claims Auditor to join our team. The ideal candidate will be responsible for processing stop loss claims, ensuring accuracy and compliance with policy terms. This role requires strong analytical skills, attention to detail, and the ability to work independently.

Responsibilities

• Review and process stop loss claims in accordance with policy terms and conditions.
• Analyze claim documentation and eligibility records to determine eligibility and coverage.
• Communicate with Third Party Administrators and brokers to gather necessary information and resolve claim issues.
• Maintain accurate and up-to-date records of all claims processed.
• Collaborate with other departments to ensure timely and accurate claim payments.
• Prepare and present reports on claim activity and trends to management.

Requirements

• Minimum of 3 years of experience in stop loss claims processing or a related field.
• Strong analytical and problem-solving skills.
• Excellent written and verbal communication skills.
• Proficiency in Microsoft Office Suite, particularly Excel and Word.
• Ability to work independently and manage multiple tasks simultaneously.

Nice-to-haves

• Knowledge of healthcare insurance and stop loss policies is preferred.
• Medical billing experience a plus.

Benefits

• Competitive salary
• PTO & paid holidays
• 401(k) with match
• Exclusive discount programs
• Health & wellness programs