Top 1580 Medical stop loss Jobs

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
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Local Delivery Driver CDL A
Etna Supply —Toledo, OH
- Full-time
- Clean driving record
- Customer service
- Basic math
- Disability insurance
- Health insurance
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Processing & Disclosure Specialist
Deerwood Bank —Baxter, MN
- $25 - $30 an hour
- Full-time
- Customer service
- Mid-level
- Office
- Health savings account
- Paid holidays
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LPN- $5,000 Sign On Bonus
Union Post Acute —Union, SC
- $25.00 - $27.75 an hour
- 12 hour shift
- CPR Certification
- Nursing
- Skilled nursing facility
- Health insurance
- 401(k) matching
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Respiratory Therapist RRT
HCA Florida Capital Hospital —Tallahassee, FL
- Full-time
- Mid-level
- Employee stock purchase plan
- Disability insurance
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Senior Maintenance Manager (Food Manufacturing)
Dessert Holdings Inc. —Aurora, CO
- $130,000 - $150,000 a year
- Full-time
- 5 years
- Engineering
- Sanitation
- Paid holidays
- Health insurance
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Part Time Police Officer (Active or Retired)
ACCEL ENTERTAINMENT —Champaign, IL
- $30 an hour
- Part-time
- Hybrid work
- Clean driving record
- Mid-level
- Ability to lift 50 pounds
- Health savings account
- AD&D insurance
Quick Apply
Local Delivery Driver CDL A or B
Etna Supply —Kalamazoo, MI
- CDL B
- Clean driving record
- Local
- Disability insurance
- Health insurance
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13d
CDL Delivery Driver
Buchheit Logistics —Sparta, IL
- From $25 an hour
- Multiple hires
- CDL B
- Construction site
- Local
- Paid holidays
- Health insurance
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Senior Construction Project Manager - SoCal
Frontline Wildfire Defense —Los Angeles, CA
- $120,000 - $134,000 a year
- Weekends as needed
- Background check
- Google Workspace
- Construction site
- Paid holidays
- Health insurance
Quick Apply
9d
Assistant Medical Director
Medical Mutual of Ohio —Ohio
- Remote
- Medicine
- 5 years
- Word processing
- Health savings account
- Disability insurance
Part Time Police Officer (Active or Retired)
ACCEL ENTERTAINMENT —Springfield, IL
- $30 an hour
- Part-time
- Hybrid work
- Clean driving record
- 7 years
- Mid-level
- Health savings account
- AD&D insurance
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Lead Respiratory Therapist RRT
HCA Florida Capital Hospital —Tallahassee, FL
- Full-time
- 5 years
- Mid-level
- Employee stock purchase plan
- Disability insurance
Quick Apply
Processing & Disclosure Specialist
Deerwood Bank —Mendota Heights, MN
- $25 - $30 an hour
- Full-time
- Customer service
- Mid-level
- Office
- Health savings account
- Paid holidays
Quick Apply
Restoration Field Team Manager
Best Cleaners NY —Schenectady, NY
- $58,000 - $65,000 a year
- Overtime
- Heavy lifting
- Mid-level
- Driver's License
- Health insurance
- Dental insurance
Quick Apply
Local Delivery Driver Full Time CDL A
Etna Supply —Wixom, MI
- $25 an hour
- Full-time
- Clean driving record
- Customer service
- Basic math
- Disability insurance
- Health insurance
Quick Apply
Field Application Engineer - A&D
TTM Technologies —Connecticut
- Full-time
- Microsoft Excel
- Engineering
- Public speaking
- Health savings account
- Paid holidays
2nd and 3rd Shift Manufacturing Team Leads (KHMS)
Kraft Heinz —Holland, MI
- $32.11 an hour
- Overtime
- Word processing
- Mid-level
- Continuous improvement
- Paid training
- Health savings account
9d
CDL A Company Truck Driver – Dedicated Route – Home Daily (Columbus, OH)
Ryan Logistics, Inc. —Columbus, OH
- $1,400 - $1,550 a week
- Full-time
- Dedicated
- Clean driving record
- No touch freight
- Paid holidays
- Dental insurance
Quick Apply
9d
Truck Driver – CDL Class A
Distribution Centers —Fredericksburg, VA
- $18.50 - $38.82 an hour
- Overnight shift
- Local
- No high school diploma
- CDL A
- Health insurance
- Dental insurance
Quick Apply
10d

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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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Medical Stop Loss Claims Auditor

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CDL A Company Truck Driver – Dedicated Route – Home Daily (Columbus, OH)

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