Top 146 Medical stop loss Jobs in Remote

Medical Stop Loss Claims Auditor
Evolution Risk Partners, LLC —Remote
- $75,000 - $85,000 a year
- Remote
- Customer service
- Writing skills
- Mid-level
- Health savings account
- Paid holidays
Quick Apply
Stop Loss Claims Coordinator
Sigmatico, LLC —Remote
- $50,000 - $60,000 a year
- Full-time
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
10d
Reinsurance Administrator (Stop Loss) - LH
Luminare Health —Remote
- $18.07 - $33.92 an hour
- Full-time
- Remote
- Microsoft Word
- Microsoft Outlook
- Mid-level
- Paid parental leave
- Paid holidays
Senior Underwriter OR AVP - Medical Stop Loss (Captives)
Skyward Specialty Insurance —Remote
- $100,000 - $170,000 a year
- Full-time
- Remote
- Writing skills
- Mid-level
- Analysis skills
- Employee stock purchase plan
- Paid holidays
Senior Underwriter or AVP, Medical Stop Loss (Core)
Skyward Specialty Insurance —Remote
- $100,000 - $170,000 a year
- Full-time
- Remote
- Writing skills
- Mid-level
- Analysis skills
- Employee stock purchase plan
- Paid holidays
Stop Loss Administrative Support Assistant
Foundation Risk Partners —Avon, CT
- Remote
- Microsoft Outlook
- Mid-level
- Administrative experience
- Paid holidays
- Disability insurance
Quick Apply
Senior Underwriter - Medical Stop Loss - Remote
Jencap —Phoenix, AZ
- Remote
- 5 years
- Finance
- Bachelor's degree
- 401(k)
- Tuition reimbursement
Quick Apply
Supervisor, Stop Loss
Allied Benefit Systems —Chicago, IL
- $60,000 - $65,000 a year
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Management
- Disability insurance
- Health insurance
7d
Specific Claims Auditor
Tokio Marine HCC —Remote
- $40,300 - $88,800 a year
- Overtime
- Background check
- Microsoft Excel
- Computer literacy
- Wellness program
- Paid parental leave
Associate Customer Care Specialist
Medical Mutual of Ohio —Rossford, OH
- Monday to Friday
- Remote
- Computer literacy
- High school diploma or GED
- Business Administration
- Health savings account
- Disability insurance
Sr Specialist Benefits
Frontdoor —Remote
- $95,000 - $110,000 a year
- Full-time
- 7 years
- Research
- Analysis skills
- Employee stock purchase plan
- Disability insurance
Claims Adjuster - Associate
Independence Pet Group —Chicago, IL
- Full-time
- Remote
- Clinic experience
- Experience equivalent to degree accepted
- 1 year
- Commuter assistance
- Paid parental leave
11d
VP, C&F Stop Loss
Crum & Forster —Eatontown, NJ
- $138,700 - $260,800 a year
- Remote
- Microsoft Excel
- Microsoft Outlook
- 11+ years
- Employee stock purchase plan
- Health insurance
Aggregate Claims Auditor
Risk Strategies —Remote
- $51,800 - $90,000 a year
- Full-time
- Microsoft Outlook
- Mid-level
- Office
7d
Clinical Risk Manager, C&F Stop Loss
Crum & Forster —Eatontown, NJ
- $67,900 - $127,600 a year
- Remote
- Nursing
- 6 years
- Microsoft Outlook
- Employee stock purchase plan
- Health insurance
Stop Loss Underwriter
Employee Benefits Captive —Las Vegas, NV
- $60,000 - $85,000 a year
- Full-time
- Remote
- Mid-level
- Children
- Negotiation
- Commuter assistance
- Paid parental leave
Contact Center Associate - Authorizations Agent - 100% Remote
Frontdoor —Remote
- $16 - $17 an hour
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Basic math
- Employee stock purchase plan
- Disability insurance
14d
Sr. Manager, Stop Loss Claims Operations - Healthcare TPA
Personify Health —Remote
- $107,000 - $140,000 a year
- Email
- 5 years
- Office
- Finance
- Health insurance
- Dental insurance
Social Media Local or Nano Accounts
Synergy Weight Loss —Remote
- $15 - $50 an hour
- Temporary
- Remote
- Internal Medicine
- Telehealth
- Entry level
- Flexible schedule
Quick Apply
9d
Sr Reinsurance Administrator - LHB
Luminare Health —Remote
- $21.65 - $40.66 an hour
- Full-time
- Remote
- Microsoft Outlook
- Research
- Mid-level
- Paid parental leave
- Paid holidays

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medical stop loss jobs near remote

Medical Stop Loss Claims Auditor

Evolution Risk Partners, LLC
Remote

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Job Details

$75,000 - $85,000 a year

Benefits

Health savings account
Paid holidays
Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Employee assistance program
Vision insurance
401(k) matching
Employee discount
Life insurance

Qualifications

Customer communication

Full Job Description

Stop Loss Claims Auditor or Senior Stop Loss Claims Auditor

The Stop Loss Auditor is responsible for auditing and authorizing reimbursements of specific claims and effectively mitigate client medical stop loss claims and provide excellent customer service.

Experience/Qualifications:

3-5+ years of experience in auditing medical Stop Loss Claims.
Audit stop loss claims and verify claims are paid in accordance with the Plan Document and reimbursable under the stop loss contract.
Timely follow-up of pending claims to ensure additional information is received.
Recognize cost mitigation opportunities.
Interpret plan languages and stop loss contracts.
Familiar with the process of referring claims for over-authority review and approval to the carrier.
Efficient communication with both internal and external customers
Experience with auditing aggregate claims
Captive experience a plus
Ability to analyze claims and/or large claim management reports to post and/or adjust reserves.

Skills/Abilities

2-3 years medical claim processing or 3-5+ years Stop Loss Claims Auditing and reinsurance experience.
Bachelor’s degree a plus.
Experience TPA Claims Processing and cost mitigation.
Proficient in Excel (for example: sorting, filtering, data, creating pivot tables.)
Ability to interpret and understand Plan Document wording and the application of provisions including eligibility.
Knowledge in COB, Medicare rules, CPT codes, REV codes, ICD-10 codes, HCPCS codes, J-codes
Excellent customer service, organizational with strong analytical skills
Detail/results-oriented
Ability to work independently with minimal supervision while meeting or exceeding established production and accuracy standards.
Ability to interpret and understand Stop Loss Contracts
Customer Service focused.
Excellent verbal and written communication skills

What We Offer:

We're proud to offer a competitive salary, generous and flexible PTO & paid holidays, 401(k) with match, exclusive discount programs, health & wellness programs, and more.

Benefits:

Health insurance
401(k)
401(k) matching
Dental insurance
Employee assistance program
Flexible spending account
Health savings account
Life insurance
Vision insurance

About Evolution Risk Partners, LLC

Evolution Risk Partners (ERP) is a full service Managing General Underwriter redefines partnership through a shared vision of success with employers and brokers. We provide organizations with customizable and innovative medical stop-loss solutions to ensure the financial stability of your self-funded medical program. Interested parties should visit www.evolutionrisk.com.

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Refine Your Search

medical stop loss jobs in remote

Medical Stop Loss Claims Auditor

Stop Loss Claims Coordinator

Reinsurance Administrator (Stop Loss) - LH

Senior Underwriter OR AVP - Medical Stop Loss (Captives)

Senior Underwriter or AVP, Medical Stop Loss (Core)

Stop Loss Administrative Support Assistant

Senior Underwriter - Medical Stop Loss - Remote

Supervisor, Stop Loss

Specific Claims Auditor

Associate Customer Care Specialist

Sr Specialist Benefits

Claims Adjuster - Associate

VP, C&F Stop Loss

Aggregate Claims Auditor

Clinical Risk Manager, C&F Stop Loss

Stop Loss Underwriter

Contact Center Associate - Authorizations Agent - 100% Remote

Sr. Manager, Stop Loss Claims Operations - Healthcare TPA

Social Media Local or Nano Accounts

Sr Reinsurance Administrator - LHB

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