Stop Loss Claims Specialist

Job Summary

A company is looking for a Stop Loss Claims Specialist I-Aggregate.

Key Responsibilities

• Compile and submit claim reports and necessary documentation for stop loss claims
• Monitor claim statuses and follow up with stop loss carriers to ensure timely reimbursements
• Appeal denied or reduced reimbursements and audit aggregate positions while tracking funding balances

Required Qualifications, Training, and Education

• High School diploma or equivalent required; some college or equivalent work experience preferred
• 1-2 years of claims experience in a self-funded environment
• Thorough knowledge of Stop Loss terminologies and catastrophic claim handling
• Proficiency in Microsoft Office Suite, especially Excel
• Accounting or Finance background is a plus