Medical Claims Administrator

Job Summary

Coordinating the receipt and tracking of stop loss claims submissions, the full-time hourly Medical Claims Administrator will manage claims processing, compile reports, and ensure quality assurance in a 100% remote environment.

Key responsibilities

• Manage stop loss claims by compiling submissions, logging notices, and ensuring complete documentation
• Review and process claims for appropriateness, facilitating funding with the Finance department
• Monitor quality assurance by recognizing trends, performing self-assessments, and collaborating to improve procedures

Required qualifications

• High School Diploma or GED required
• Associates degree in Medical Billing and Coding or a related field
• 2+ years of experience in administrative and customer service roles
• Understanding of Medical Third-Party Administration functions and medical terminology preferred
• Proficiency in Microsoft Office products