Stop Loss Claims Specialist II

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Compile and submit reports and necessary documentation for stop loss claims.

• Monitor the status of assigned claims and follow up with stop loss carriers.

• Address inquiries and requests for additional information from carriers.

• Collaborate with internal departments to resolve any claim-related issues.

• Appeal any denied or reduced reimbursement claims.

• Submit stop loss claims to priority carriers.

• Coordinate with Stop Loss Team Members regarding priority claims.

• Process high-dollar claims.

• Retain essential provider documents as required by carriers.

• Provide training to team members on departmental processes and workflows.

• Foster relationships with priority carriers.

• Undertake additional duties as assigned.

⛳️ Requirements

• High School Diploma or GED is a must.

• A minimum of 2 years of experience in stop loss claim filing is required.

• Experience with medical claims is essential.

• Proficiency in Microsoft Office Suite or similar software is necessary.

• Strong analytical and problem-solving abilities are needed.

• Excellent verbal and written communication skills are essential.

• Exceptional organizational skills and attention to detail are required.

• Strong time management skills with a proven ability to adhere to deadlines are essential.

• Reliable cable broadband or fiber optic internet service with a minimum of 100Mbps download/25Mbps upload speed is required.

• A college degree is preferred.

• A background in Accounting or Finance is a plus.

🏝️ Benefits

• Medical insurance.

• Dental insurance.

• Vision insurance.

• Life and disability insurance.

• Generous paid time off.

• Tuition reimbursement.

• Employee Assistance Program (EAP).

• Technology stipend.

• Fully remote work.

• Flexible work-from-home arrangement.