Tmhcc
Aggregate Claims Auditor
Remote - USA
Sponsorship not specified$51k-$112kDetected 9 days ago
AuditingUnityICD-10CommunicationCollaboration
About the role
- Under supervision, investigates claims liability and determines the extent of liability on submitted claims for an overall contract that is approaching or exceeds the aggregate attachment point.
- Accurately processes the claim according to the policies or contracts that exist, within the departmental time frames and standards, and establishes reserves for claim liability.
Responsibilities
- Interpret paid claims reports, eligibility reports, funding documentation, check registers, prescription reports to verify contract/plan document is being followed correctly.
- Maintain quality, quantity, and turnaround time standards of company.
- Review the TPA/client operations to verify in guidelines of contract/plan documents
Requirements
- 2 Years relevant and progressive professional experience in auditing and claims
- Possess and have ability to apply broad knowledge of principles, practices, and procedures
Compensation
- The pay range for this position is $50,500-$111,500, which includes geographic adjustments, where applicable.
- The pay range is the range THMCC, in good faith, believes is the range of compensation for this role at the time of this posting.
Benefits
- Competitive salary and comprehensive benefit package
- Strong learning culture with ongoing development opportunities
- Comprehensive medical, vision, and dental coverage, with eligibility beginning on your first day of employment
- Basic life and disability insurance
- 20 days of PTO, two floating holidays, approximately 11 paid holidays, and volunteer time off
- Paid parental leave
- Access to our award-winning wellness program, including mental health services, fitness network membership, and a complimentary Headspace subscription
- The hired applicant will be offered pay within the entire range based on the candidate's geographic location, qualifications, work experience, education, and/or skill level.
Company info
- Tokio Marine HCC is a leading specialty insurance group with offices in the United States,the United Kingdom, Europe, and other exciting locations.
- With the strength and stability that comes from being a member of the Tokio Marine Group, and more than fifty years of growth, profitability, and stability, we offer important insurance products that most people don't even know exist.
- Every policy we write is special, enabling our clients to do amazing things.
- For over 50 years, HCC Life Insurance Company, operating as Tokio Marine HCC - A&H Group, has been at the forefront of medical stop loss insurance.
- In addition to traditional stop loss, we offer captive and Taft-Hartley stop loss solutions, level funded stop loss, Organ & Tissue Transplant insurance and MedPlus insurance.
- Tokio Marine HCC - A&H Group is rated A++ (Superior) by A.M. Best Company and benefits from the financial stability of its parent company, Tokio Marine HCC.
- Applying our Mind Over Risk philosophy to writing insurance allows our customers to take on opportunity with confidence.
- That philosophy defines our way of thinking, unites us as a team, and differentiates us from our competitors.
- We are much more than just an insurance company; we are a good company.
- Equal Opportunity Employer
- TMHCC is an equal opportunity employer.
- All qualified applicants will receive consideration for employment without regard to age, ancestry, citizenship, color, family or medical care leave, gender identity, genetic information, marital status, medical condition, national origin, physical or mental disability, protected veteran or military status, race, ethnicity, religion, sex (including pregnancy), sexual orientation, or any other characteristic protected by applicable local laws, regulations and ordinances.
- Opportunities for growth and career advancement
Equal opportunity
- Employer
- TMHCC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to age, ancestry, citizenship, color, family or medical care leave, gender identity, genetic information, marital status, medical condition, national origin, physical or mental disability, protected veteran or military status, race, ethnicity, religion, sex (including pregnancy), sexual orientation, or any other characteristic protected by applicable local laws, regulations and ordinances.
- #stoploss1
Visa & Work Authorization
- ardless of color, race, sex, national origin, sexual orientation, religion, age, veteran status, disability, pregnancy, citizenship status, genetic information, or any other basis protected by federal, state, or local pa
This listing is sourced directly from Tmhcc's careers page and normalized into a canonical job model.