[Hiring] Accident and Health Claims Auditor @One80 Intermediaries

Role Description

One80 Intermediaries is seeking an Accident and Health Claims Auditor to join our growing team! In this role, you will be responsible for reviewing and analyzing claims to ensure they are processed accurately and in accordance with policy provisions. You will handle moderate to complex claim issues, ensuring that all necessary documentation is obtained, and claims are either approved or denied based on established guidelines.

• Analyze and research claim issues of moderate to complex difficulty.
• Ability to comprehend complicated workflows, policy certificates, and policy provisions.
• Review and apply policy provisions in processing of claims received.
• Request and obtain necessary documents for claim processing/consideration, including scheduling follow-ups for documentation.
• Release of accurate benefit payments in accordance with CBP policy, industry standard & other applicable TPA or SLA agreements.
• Proper documentation of required information in claim system, including follow up information.
• Receive inbound calls within assigned queues and/or as an overflow for the CSR team.

Qualifications

• High School Diploma or equivalent.
• Ability to function independently within established guidelines.
• Excellent interpersonal, oral and written communication skills.
• Intermediate skill level in Microsoft Office programs.

Benefits

• Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance.
• Financial Benefits: ESPP; 401k; Student Loan Assistance; Tuition Reimbursement.
• Mental Health & Wellness: Free Mental Health & Enhanced Advocacy Services.
• Beyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts and more.

Company Description

One80 Intermediaries is part of Arrowhead Intermediaries, a global insurance distribution platform that offers deep specialization, scale, and innovation across wholesale brokerage, program administration, and specialty insurance. With more than 7,000 professionals worldwide and a collective portfolio exceeding $18 billion in premium placed in 2024, our combined organization delivers a diverse trading platform for insurance carriers as well as expanded access and niche solutions for brokers and customers navigating complex and hard-to-place risks. The platform combines entrepreneurial culture with operational excellence to deliver tailored solutions and long-term value across the insurance ecosystem.