Senior Claims Reviewer
Arlo · New York City, New York, US
About Arlo AI is changing how people access their health care - but traditional incumbent carriers are far behind. Thousands of people delay care every day,...
Job description
About Arlo AI is changing how people access their health care - but traditional incumbent carriers are far behind. Thousands of people delay care every day, because of financial fear and lack of support from their health insurance to seek the care they need. Arlo’s mission is to make high-quality health coverage simple, affordable, and transparent — helping employers offer benefits that actually feel like benefits. We’ve grown from zero to tens-of-thousands of covered members in under a year, and we’re just getting started. The Opportunity: Arlo is hiring for an experienced Claims Reviewer to join our stop-loss and medical claims operations team. This role is responsible for reviewing aggregate claims as well as high-cost and complex claims, ensuring accurate adjudication, and identifying opportunities for cost containment and fraud prevention. You will play a critical part in protecting Arlo’s clients and ensuring every claim is processed accurately, efficiently, and in line with plan provisions. What you will do: - Review stop-loss and large medical claims for accuracy, completeness, and compliance with plan terms. - Adjust and re-adjudicate claims where errors, inappropriate bil...