Stop Loss Claims Specialist

Job Summary

Responsible for preparing and filing medical stop loss claims for reimbursement, the full-time Stop Loss Claims Specialist will work remotely to ensure timely reimbursements, handle appeals for denied claims, and train team members on departmental processes.

Key responsibilities

• Compile and submit claim reports and necessary documentation for stop loss claims
• Monitor claim statuses and follow up with stop loss carriers for timely reimbursements
• Train team members on departmental processes and workflows

Required qualifications

• High School Diploma or GED required; college degree preferred
• Minimum 2 years of stop loss claim filing experience
• Experience in medical claims is required
• Proficient in Microsoft Office Suite or related software
• Accounting or Finance background is a plus