Health Claims Specialist

A company is looking for a Health Claims Stop Loss Specialist. Key Responsibilities Prepare Stop Loss claims and documents to determine filing eligibility Process submissions of spec claimants and coordinate Advanced Funding Requests Maintain a database of reimbursement requests and generate weekly outstanding reimbursement reports Required Qualifications High school diploma or GED required Minimum three years of related experience or equivalent combination of education and experience Completion of training programs through HIPAA, ICA, and/or LOMA preferred Knowledge of medical terminology, CPT, HCPCS, and ICD-10 codes Computer literate with knowledge of Microsoft Office applications

Apr 1, 2025 - 15:35

A company is looking for a Health Claims Stop Loss Specialist. Key Responsibilities Prepare Stop Loss claims and documents to determine filing eligibility Process submissions of spec claimants and coordinate Advanced Funding Requests Maintain a database of reimbursement requests and generate weekly outstanding reimbursement reports Required Qualifications High school diploma or GED required Minimum three years of related experience or equivalent combination of education and experience Completion of training programs through HIPAA, ICA, and/or LOMA preferred Knowledge of medical terminology, CPT, HCPCS, and ICD-10 codes Computer literate with knowledge of Microsoft Office applications