Stop Loss Claims Specialist I
About this role
Overview
POSITION SUMMARY The Stop Loss Claim Specialist is responsible for preparing and filing medical stop loss claims for reimbursement with stop loss carriers for individual stop loss (specific) coverage. Additional duties include following up with the various carriers to ensure reimbursements are received in time and in full. Further responsibilities include the appeals of denied and reduced claim reimbursements, along with retaining the appropriate documentation needed to support the reimbursement request.
ESSENTIAL FUNCTIONS
- Compile and submit claim reports and the necessary documentation to file a stop loss claim.
- Frequently monitor the status of claims assigned and follow up with stop loss carriers.
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