Medical Claims Coordinator
A company is looking for a Medical Claims Coordinator to support healthcare operations by auditing and adjudicating medical stop loss claims. Key Responsibilities Review and audit medical stop loss claims for compliance with plan documents and contracts Collaborate with finance to facilitate approved claim payments and communicate decisions with third-party administrators Monitor claim trends, generate reports, and perform self-audits to improve accuracy and efficiency Qualifications High School Diploma or GED required; Bachelor's degree in Medical Billing and Coding or related field preferred Minimum 5 years of experience in medical claims administration Familiarity with medical terminology and third-party administration processes Proficiency in Microsoft Office and relevant computer applications Strong organizational and analytical skills
A company is looking for a Medical Claims Coordinator to support healthcare operations by auditing and adjudicating medical stop loss claims.
Key Responsibilities
Review and audit medical stop loss claims for compliance with plan documents and contracts
Collaborate with finance to facilitate approved claim payments and communicate decisions with third-party administrators
Monitor claim trends, generate reports, and perform self-audits to improve accuracy and efficiency
Qualifications
High School Diploma or GED required; Bachelor's degree in Medical Billing and Coding or related field preferred
Minimum 5 years of experience in medical claims administration
Familiarity with medical terminology and third-party administration processes
Proficiency in Microsoft Office and relevant computer applications
Strong organizational and analytical skills
