Teams at Risk Strategies

Perform high-level reviews of aggregate stop loss and accommodation claims, validate eligible expenses under stop loss contracts, evaluate enrollments and attachment calculations, produce audit reports and exhibits within company timeframes, and support process improvements and implementation.

Lead data-driven initiatives to analyze complex datasets, build dashboards, present insights to leadership, and drive continuous improvement projects to improve operational performance and inform strategic decisions.

Conduct detailed audits of high-complexity stop-loss claims to ensure accuracy, compliance, and adherence to procedures. Document findings, recommend corrective actions, identify trends, collaborate with departments, and support audit reporting and analytics.