Stop Loss Claims Analyst
Location: Remote
Compensation: Salary
Reviewed: Mon, Apr 07, 2025
This job expires in: 10 days
Job Summary
A company is looking for a Stop Loss Claims Analyst to evaluate claim submissions for reimbursement eligibility.
Key Responsibilities
- Process an average of 5 to 7 claims per day with a 99% accuracy rate
- Determine eligibility of claims by applying contractual provisions to medical facts
- Document claim decisions and elevate issues as necessary
Required Qualifications
- 5+ years of stop loss claims experience
- Prior experience with first dollar payer insurance and medical healthcare claims
- Familiarity with medical billing practices, CPT codes, and revenue codes
- Ability to use mathematics for claim adjudication
- Proficiency in Microsoft Office software
COMPLETE JOB DESCRIPTION
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