Supervisor, Claims Audit - Medical Stop Loss

Skyward Specialty Insurance

Kennesaw, GA, US
Base: $80,000 - $90,000; bonus/equity: performance...
Hybrid
5-7+ years medical claims auditing experience
Supervisory or lead role in stop loss industry
Advanced knowledge of icd-10 cpt hcpcs coding
Skyward Specialty Insurance is seeking a Supervisor for their Claims Audit team focused on Medical Stop Loss policies. The role involves leading a team of auditors, ensuring compliance and accuracy in claims processing, and collaborating with various stakeholders to enhance client satisfaction

Job Summary

  • The Supervisor will lead a team of claims auditors focused on reviewing liability for Medical Stop Loss policies issued to non-captive clients.
  • This role requires overseeing audits across Skyward insurance programs to monitor over/under payments, duplicate payments, and contract compliance.
  • The position offers a competitive total rewards package including health benefits, 401k savings, and professional certification assistance.

Matching Summary

Match Score: 85

Skyward Specialty Insurance is seeking a Supervisor for their Claims Audit team focused on Medical Stop Loss policies. The role involves leading a team of auditors, ensuring compliance and accuracy in claims processing, and collaborating with various stakeholders to enhance client satisfaction.

Salary

Base: $80,000 - $90,000; Bonus/Equity: Performance-based incentives eligible; Benefits: Health/welfare, tuition assistance, 401k, stock purchase program, PTO, paid holidays, child bonding leave

Skills & Requirements

Must-have

  • 5-7+ years medical claims auditing experience
  • Supervisory or lead role in stop loss industry
  • Advanced knowledge of ICD-10 CPT HCPCS coding
  • Experience managing accident and health claims teams
  • Proficiency interpreting Plan Documents and reinsurance contracts

Nice-to-have

  • Experience with aggregate claims processing
  • Familiarity with Medicare COBRA FMLA guidelines
  • Strong analytical skills with attention to detail
  • Ability to foster collaborative team environment
  • Project management abilities for process enhancements

Key Requirements

  • Bachelor's degree in business, Insurance, or related field
  • 5-7+ years progressive experience in medical claims auditing
  • Experience in a supervisory or lead role within stop loss insurance
  • Demonstrated expertise in medical stop loss claims audit

Work Rights

Not specified

Tailored Resume

Cover Letter