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Crum & Forster

Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry. Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2025 Great Place to Work® Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion. C&F is part of Fairfax Financial Holdings, a global, billion dollar organization.

Claims Examiner, Medical Stop Loss

Claims SpecialistClaims SpecialistFull TimeRemoteSeniorTeam 1,001-5,000H1B No SponsorCompany SiteLinkedIn

Location

Arizona

Posted

47 days ago

Salary

$48.3K - $90.8K / year

Seniority

Senior

Bachelor Degree3 yrs expEnglish

Job Description

• Within documented authority levels, review all claim submissions for accuracy, completeness, and compliance with various Plan Documents, SPDs, and Policies • Clearly and professionally communicate external requests for information and maintain timely follow-up • Clearly and professionally communicate claim payment and denial decisions • Confirm appropriate disclosure when applicable • Calculate and maintain reserves as needed • Assist with aggregate accommodation activities and aggregate claim submissions • Maintain appropriate reporting and communication with team and management regarding your assigned areas of responsibility • Assist with refining internal claim procedures and recommending improvements to management • Other duties as assigned

Job Requirements

  • 3+ years medical stop loss claim experience required
  • Bachelor’s degree or equivalent experience required
  • Strong working knowledge of both Microsoft Office suite with an aptitude to learn new programs (ESL Office experience preferred)
  • Ability to establish a good rapport with all stakeholders
  • Commitment to delivering outstanding customer service and satisfaction
  • Commitment to exploring and assisting in implementing new processes to increase effectiveness and achieve organizational goals
  • Exceptional attention to detail and accuracy
  • Capability to manage multiple priorities in a fast-paced environment
  • Excellent written and verbal communication skills

Benefits

  • Competitive compensation package
  • Generous 401K employer match
  • Employee Stock Purchase plan with employer matching
  • Generous Paid Time Off
  • Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family’s wellness, including your physical, mental and financial wellbeing
  • A core C&F tenet is owning your career development, so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training to keep you progressing on your chosen path
  • A dynamic, ambitious, fun and exciting work environment
  • We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community

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