Medical Claims Administrator

Job Summary

To support efficient claims processing, the full-time hourly Medical Claims Administrator will coordinate the receipt, tracking, and documentation of stop loss claims submissions while working remotely.

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
• Recognize and document trends in claims, providing feedback to optimize quality performance and improve internal processes

Required qualifications

• High School Diploma or GED required
• Associate's 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
• Proficient in Microsoft Office products and demonstrated organizational skills