Health Claims Stop Loss Specialist

A company is looking for a Health Claims Stop Loss Specialist. Key Responsibilities Prepare Stop Loss claims and determine filing eligibility for the Excess Loss Policy Process submissions of spec claimants and coordinate Advanced Funding Requests with clients and carriers Maintain a database of reimbursement requests and generate reports on outstanding reimbursements Required Qualifications High school diploma or GED required Minimum three (3) 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

Mar 13, 2025 - 23:27

A company is looking for a Health Claims Stop Loss Specialist. Key Responsibilities Prepare Stop Loss claims and determine filing eligibility for the Excess Loss Policy Process submissions of spec claimants and coordinate Advanced Funding Requests with clients and carriers Maintain a database of reimbursement requests and generate reports on outstanding reimbursements Required Qualifications High school diploma or GED required Minimum three (3) 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