{"id":1311691,"url":"https://alion.io/job/bbrown-specific-stop-loss-claims-auditor","title":"Specific Stop Loss Claims Auditor","company":{"id":1779108,"name":"Brown & Brown","domain":"bbrown.com","url":"https://alion.io/company/brown-and-brown","size_band":"1001-5000","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Workday","truth_index":{"grade":"A","score":86,"open_postings":18,"ghost_share":0,"stale_share":0.778,"repost_share":0,"time_to_fill_p50_days":16,"computed_at":"2026-10-17T05:46:00Z"}},"role":"Finance","role_family":"Finance","seniority":"junior","employment_type":"full_time","work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"board_field","remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["United States"],"countries":["US"],"hiring_countries":["US"],"hiring_countries_total":1,"salary":null,"salary_estimate":{"min_usd":40000,"max_usd":79000,"period":"year","method":"role_seniority_country_remote_cell","sample_n":232},"experience_years_min":2,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Microsoft Excel","optional":false},{"name":"Microsoft Office","optional":false},{"name":"Outlook","optional":false}],"status":"live","first_seen_at":"2026-09-21T00:00:00Z","employer_posted_date":"2026-09-21","last_verified_at":"2026-10-18T11:46:52Z","board_verified":true,"closed_at":null,"days_open":28,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":28},"description":"Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers.\nBrown & Brown is seekinga Specific Stop Loss Claims Auditor to join our growing team.\nCorporate Benefit Audits, Inc. (CBA), a division of Risk Strategies Company, headquartered in North Andover, MA since 1992, has provided audit services to Carriers, MGU’s, Reinsurers and Employer clients managing healthcare risk and associated Stop Loss Reinsurance concerns. The incumbent is responsible forproviding Specific Stop Loss claims auditing services for MGU and/or Carrier clients.\nHow You Will Contribute:\nAnalyze Specific Stop Loss claims.\n\nIdentifyand isolate the data that is specific to a particular claim submission.\n\nValidate which expenses are eligible under the stop loss policy and summary plan description.\n\nAccurately apply all deductibles, coinsurances, aggregating specific deductibles and lasers.\n\nProvide customer service for MGU partners and their respective TPAs.\n\nConduct timelyfollow up on all pendedclaims.\n\nContribute innovative ideas and assistwith the implementation of new processes.\n\nSkills & Experience to be Successful:\nMust have Excel Proficiency to include knowledge of basic formulae, sorting techniquesand PIVOT Tables.\n\nMinimum 2 years Claims experience with first dollar medical claims, specific and/or aggregate claims, HMO reinsurance and/or provider excess claims.\n\nclaims, HMO reinsuranceand/or provider excess claims.\n\nPrior experience with industry repricing methodologies. (PPO, Wrap Networks, Reference Based Pricing,etc.).\n\nDemonstrated proficiencyin Microsoft Office, includingMicrosoft Outlook.\n\nDemonstrated strong analytical/critical thinking skills;and detail-oriented focus.\n\nStrong written and verbal communication skills.\n\nAbility to work independently with minimal supervision.\n\nPreferred\nPrior experience auditing managed care or specific/aggregate stop loss claims.\n\nHistory of successful Process Improvement initiatives.\n\nPay Range\n75,000.00 - 90,000.00 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.\nTeammate Benefits & Total Well-Being\nWe go beyond standard benefits, focusing on the total well-being of our teammates, including:\nHealth Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance \nFinancial Benefits: ESPP; 401k; Student Loan Assistance; Tuition Reimbursement \nMental Health & Wellness: Free Mental Health & Enhanced Advocacy Services\nBeyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts and more. \nNot 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.\nRecruiting Vendor Disclosure Statement\nBrown & 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.\nThe Power To Be Yourself\nAs 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”.","description_format":"text","description_chars":3850,"description_truncated":false,"requirements":{"experience_years_min":2,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":null,"security_clearance":false,"languages":[]},"benefits":["401k plan","Life insurance"],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Financial Services","Jewelry","Property & Casualty Insurance"],"lifecycle":[{"event":"open","at":"2026-09-26T16:45:48Z"}],"visa":[{"country":"US","licensed_sponsor":true,"evidence":"H-1B filings in 12 months: 1","filings_12m":1,"filings_prev_12m":0,"green_card_filings_12m":0,"median_offered_wage_usd":132500,"route":null,"cap_exempt":false,"checked_at":"2026-10-15T11:24:14+00:00","sources":["US Department of Labor: LCA disclosure data (H-1B, H-1B1, E-3)"],"filings_for_role_12m":0}],"liveness":{"score":19,"band":"cold","label":"Long shot","p_open":1,"p_active":0.422,"p_room":0.45,"age_days":26,"expected_fill_days":16,"reasons":["conf:1","stale_co","velocity","win:tail","comp:junior,brand"],"computed_at":"2026-10-17T05:46:00Z"},"pay":null,"html_url":"https://alion.io/job/bbrown-specific-stop-loss-claims-auditor","json_url":"https://alion.io/job/bbrown-specific-stop-loss-claims-auditor.json","meta":{"generated_at":"2026-10-19T05:26:11Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":3259,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-20T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":1779108},"rest":"https://alion.io/mcp/rest/get_company?id=1779108"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fbbrown-specific-stop-loss-claims-auditor"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fbbrown-specific-stop-loss-claims-auditor"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fbbrown-specific-stop-loss-claims-auditor"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/bbrown-specific-stop-loss-claims-auditor\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fbbrown-specific-stop-loss-claims-auditor"}]}