Top 1582 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
Quick Apply
Claims Specialist - Accident and Health (Medical Stop Loss)
QBE —Marblehead, MA
- Full-time
- Remote
- Mid-level
- US work authorization
- Experience equivalent to degree accepted
- Tuition reimbursement
- 401(k) matching
Medical Stop Loss Claims Group Insurance
Prudential —Newark, NJ
- $106,000 - $174,900 a year
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Bachelor's degree
- Employee stock purchase plan
- Disability insurance
3d
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
10d
Senior Claims Specialist - Accident & Health (Medical Stop Loss)
QBE —Marblehead, MA
- Full-time
- Remote
- Mid-level
- US work authorization
- Experience equivalent to degree accepted
- Tuition reimbursement
- 401(k) matching
Senior Underwriter - Medical Stop Loss
Jencap —Danvers, MA
- Remote
- 5 years
- Finance
- Bachelor's degree
- 401(k)
- Tuition reimbursement
Quick Apply
Medical Stop Loss Underwriting Consultant
HM Insurance Group —Pennsylvania
- $94,200 - $151,000 a year
- Full-time
- Remote
- 6 years
- Computer Science
- Office
10d
Revenue Analyst-Healthcare Stop Loss (Remote)
Allied Benefit Systems —Chicago, IL
- $55,000 - $65,000 a year
- Full-time
- Remote
- Microsoft Excel
- Microsoft Access
- Mid-level
- Disability insurance
- Health insurance
13d
Stop Loss Revenue Associate
Allied Benefit Systems —Chicago, IL
- $20 - $23 an hour
- Full-time
- Remote
- Microsoft Excel
- Customer service
- Administrative experience
- Disability insurance
- Health insurance
9d
Regional Sales Director, Medical Stop Loss
Prudential —Chicago, IL
- Full-time
- Remote
- Up to 50% travel
- 8 years
- Continuous improvement
- Employee stock purchase plan
- Disability insurance
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
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
Claims Support Specialist, Medical Stop Loss - Hybrid
Crum & Forster —Scottsdale, AZ
- $34,800 - $51,000 a year
- Mid-level
- Office
- High school diploma or GED
- Employee stock purchase plan
- Health insurance
Stop Loss Claims Specialist I-Specific
Allied Benefit Systems —Chicago, IL
- $23 - $24 an hour
- Full-time
- Remote
- High school diploma or GED
- Analysis skills
- Accounting
- Disability insurance
- Health insurance
Premium Operations Associate, Medical Stop Loss - Hybrid
Crum & Forster —Scottsdale, AZ
- $38,300 - $56,200 a year
- Research
- Mid-level
- Microsoft Office
- Employee stock purchase plan
- Health insurance
Stop Loss Claims Specialist II-Specific
Allied Benefit Systems —Chicago, IL
- $24 - $26 an hour
- Full-time
- Remote
- Mid-level
- Finance
- High school diploma or GED
- Disability insurance
- Health insurance
Stop Loss Claims Analyst
Kismet Risk Management Associates, LLC —Remote
- From $40,000 a year
- Full-time
- Mid-level
- Communication skills
- Health insurance
- Dental insurance
Quick Apply
11d
Account Representative
MedBen —Newark, OH
- Overtime
- Background check
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
Local Delivery Driver CDL A
Etna Supply —Toledo, OH
- Full-time
- Clean driving record
- Customer service
- Basic math
- Disability insurance
- Health insurance
Quick Apply
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
Quick Apply

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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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Stop Loss Claims Specialist II-Specific

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Local Delivery Driver CDL A

LPN- $5,000 Sign On Bonus

I want to receive the latest job alert for medical stop loss

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