Health Claims Stop Loss Specialist

Job Summary

A company is looking for a Health Claims Stop Loss Specialist.

Key Responsibilities

• Prepare Stop Loss claims and determine filing eligibility for the Excess Loss Policy
• Process submissions of spec claimants and coordinate Advanced Funding Requests with clients and carriers
• Maintain a database of reimbursement requests and generate reports on outstanding reimbursements

Required Qualifications

• High school diploma or GED required
• Minimum three (3) years of related experience or equivalent combination of education and experience
• Completion of training programs through HIPAA, ICA, and/or LOMA preferred
• Knowledge of medical terminology, CPT, HCPCS, and ICD-10 codes
• Computer literate with knowledge of Microsoft Office applications