Stop Loss Claims Specialist

Job Summary

Reviewing complex claims and making informed decisions, the full-time Stop Loss Claims Specialist will work remotely or in one of the major office locations, providing direction on excess risk claims and mentoring less experienced claims staff.

Key responsibilities

• Review complex claims and provide informed decisions, including directions on excess risk claims
• Respond to internal and external inquiries from managers, brokers, and administrators regarding claims
• Manage claim suspense accounts to ensure accurate processing and financial reporting

Required qualifications

• High School Diploma or GED
• 3-5 years of claims or insurance experience
• Proficiency in MS Excel, including macros, pivots, and formulas
• Demonstrated leadership skills and experience in mentoring staff
• Knowledge of industry-related claim systems and practices