Claims Auditor-Stop Loss (Hybrid)
Location: Woodbury, New Jersey
Job Type: Full time
Excess Reinsurance, a market leader in the self-funded medical insurance market, is seeking a full-time claims auditor to join our team. The Claims Auditor is responsible for auditing and authorizing reimbursements of specific medical stop loss claims. Candidates should have three years’ experience working in the medical insurance industry.
Essential Duties and Responsibilities:
- Audit reimbursement requests of specific and aggregate stop loss medical claims submitted by Third Party Administrators
- Analyze stop loss claims and determine that they are payable in accordance with the plan document and excess loss policy
- Investigate medical process through reports and invoices for medical necessity of care
- Determine status of claims for reimbursement or denial
- Communicate effectively with outside contacts such as TPAs and brokers
Education and/or Experience:
- Minimum three years’ experience as a medical claims’ examiner and/or Stop Loss claims auditor
- Knowledge of medical terminology and disease processes
- Good reasoning and analytical skills are essential
- Must be proficient in Microsoft products, especially Excel
- Must possess excellent verbal and written communications skills
- Ability to work independently and in a team environment
**Candidate selected will be required going to the office 4x a week**
Who We Are
We’re NFP, a four-time Best Places to Work award winner in Business Insurance for 2017, 2018, 2019, and 2020. We are also recognized as an Elite 2018 Agency award winner named as a Top Employee Benefits Firm. We are a leading Insurance Broker and Consultant that provides Employee Benefits, Property & Casualty, and Retirement and Individual Private Client solutions to help our clients reach and realize their goals because we believe business is personal. Our personal commitment to our team and our clients have created long-lasting and successful relationships across our growing 300+ nationwide offices and 17 international locations. To learn more, please visit: https://www.nfp.com/
What We Offer
Excess Reinsurance offers a competitive salary and benefits including medical, dental, and vision, 401(k), and paid time off.
Office is located in Woodbury, NJ approximately 12 miles from Philadelphia.
NFP is proud to offer a competitive salary, PTO & paid holidays, 401(k) with match, exclusive discount programs, health & wellness programs, and more. Our PeopleFirst culture focuses on building and nurturing lifelong relationships with our employees because, at the end of the day, we exist to be there for others.
NFP and You... Better. Together.
NFP is an inclusive Equal Employment Opportunity employer.