Stop Loss Claims Specialist

Job Summary

Working remotely in a full-time capacity, the Stop Loss Claims Specialist will manage the tracking, monitoring, and documentation of stop loss claims while ensuring compliance with reporting requirements.

Key responsibilities

• Compiles and submits stop loss claims to the carrier for reimbursement and manages large case notifications
• Acts as a customer service role model, providing timely follow-up and escalating difficult issues as needed
• Participates in quality assurance initiatives to improve customer satisfaction and streamline internal processes

Required qualifications

• High School Diploma or GED
• 1+ years of experience in clerical and customer service roles
• Knowledge of medical terminology
• Proficiency in Microsoft Office and strong mathematical skills
• Demonstrated ability to work independently and manage multiple priorities effectively