Stop-Loss Claims Manager

Job Summary

Stop-Loss Claims Manager oversees the administration and resolution of stop-loss insurance claims, ensuring compliance and timely processing in a full-time, remote position.

Key Responsibilities

• Review and process complex stop-loss claims to ensure compliance with policy terms
• Analyze large-dollar claims for coverage issues and reimbursement eligibility
• Collaborate with stakeholders to gather documentation and clarify claim details

Required Qualifications

• 2-5 years of relevant experience in stop-loss insurance or medical claims
• High school diploma or equivalent
• Understanding of healthcare regulations
• Proficiency in data analytics tools and Microsoft Office applications
• Ability to manage sensitive health information professionally