Working remotely in a full-time capacity, the Stop Loss Claims Auditor will manage claims examination, auditing, and processing while demonstrating proficient knowledge of Stop Loss processes and procedures. Key responsibilities Audit submitted claims for accuracy and compliance with relevant plans and policies Compile and review claims information, including health plans and insurance contracts Respond to customer inquiries regarding claims and provide timely support Required qualifications Associate or Bachelor's Degree or a combination of experience and education 3-5 years of experience processing first dollar medical claims Experience in processing Stop Loss Claims Prior experience in self-insured plan management Familiarity with legal risks and regulatory guidelines related to HIPAA and the Affordable Care Act