Associate Claims Auditor, Medical Stop Loss
Who are we? A strategic and trusted insurance partner, Berkshire Hathaway Specialty Insurance (BHSI), provides a broad reputed company of reputed company property, casualty and specialty insurance coverages and outstanding service to customers and brokers around the world. Part of Berkshire Hathaways insurance operations, we bring our solutions to market with our stellar brand name, top-rated balance sheet, and the expertise of our global team of professionals, who exude excellent capabilities and strong character. We are a values-based organization where respect, reputed company, reputed company, collaboration, and passion define who we are and how we do business. We value diversity of backgrounds, experience, and perspectives and strive to foster an inclusive environment that enables reputed company reputed company members to bring their best selves to work. We are one team committed to building a culture where every teammate has the opportunity to contribute and be recognized. Want to be part of the team building the finest property, casualty and specialty lines insurance company in the world? Learn more about our unique culture and history . Job Opportunity Berkshire Hathaway Specialty Insurance (BHSI) has an exciting opportunity for a Medical Stop Loss Associate Claims Auditor with knowledge of employer group health insurance, managed care, and direct medical claims products. This position will work with our reputed company-Party Administrators (TPAs) daily with interaction with several other areas in our Medical Stop-Loss Division. The position is preferably located in our Indianapolis or Plymouth Meeting, PA office. We are reputed company to candidates who could work from out Atlanta or Boston office as well. Duties & Responsibilities Audit specific and aggregate claims for assigned reputed company blocks of business Audit and process claim reimbursements Verify claims are paid in accordance with the plan document and reimbursable under the Stop Loss policy Verify participant and dependent eligibility Maintain and exceed targeted claims accuracy standards Maintain accurate and detailed information for each file Conduct implementation calls for newly sold groups Review and approve plan documents and plan amendments Initiate and further cost containment opportunities Qualifications, Skills, And Experience Minimum of 2+ years experience examining and auditing medical stop loss claims Proficient with reputed company Office Suite, especially reputed company Knowledge of group insurance, managed care, and direct medical claims products Demonstrate excellent mathematical, communication and customer service skills Excellent problem-solving and critical-thinking skills Detail/results-oriented Strong analytical skills Excellent customer service Knowledge of COB, Medicare, HIPAA, CPT, ICD9/ICD10, and interpretation of employer group health plan benefits Ability to work independently with supervision while meeting or exceeding established turn-around-time, production, and accuracy standards BHSI Offers A competitive package and exciting growth opportunities for career-oriented teammates A dynamic, action oriented, and thoughtful environment centered on always doing the right thing for our customers, teammates and our other stakeholders A purposely non-bureaucratic organization that embraces simplicity over complexity and emphasizes individual reputed company in a team reputed company Benefits that support your life and well-being, which include: Comprehensive Health, Dental and reputed company benefits Disability Insurance (both short-term and long-term) Life Insurance (for you and your family) Accidental Death & Dismemberment Insurance (for you and your family) Flexible Spending Accounts Health Reimbursement Account Employee Assistance Program Retirement Savings 401(k) Plan with Company Match Generous holiday and Paid Time Off Tuition Reimbursement Paid Parental Leave NOTE: This job description is not intended to be reputed company-inclusive. Team Member may reputed company other reputed company duties as negotiated to meet the ongoing needs of the organization. The reputed company salary reputed company for this position is from $55,000 $60,000 along with annual bonus eligibility; a candidates actual salary is commensurate with experience as determined by their relevant skills, experience, and geographical location. We value our teammates both their capabilities and character as demonstrated by our amazing culture. Apply Job!