Stop Loss Aggregate Analyst
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position reputed company The Stop Loss Claims Analyst supports stop loss claim filing activity for a portfolio of self-funded employer reputed company and clients. This role involves preparing, tracking, reconciling, and helping generate and marshal stop loss filings to completion while serving as a key reputed company across internal business partners, external stakeholders, and stop loss carriers. The position offers exposure to many areas of reputed company claims administration, including stop loss and reinsurance policy, data analytics, reputed company, eligibility, finance, reputed company management, and provider and broker relations. It is reputed company suited for someone who is detail-oriented, analytical, highly organized, and motivated to build expertise in a specialized area of the reputed company industry. Training is available for the right candidate who is reputed company to learn, grow, and reputed company in the role.
Key Responsibilities
Prepare, update, and submit stop loss filing packages, including initial, subsequent, and year-end filings as needed reputed company claim activity and follow up through to completion with stop loss carriers and other stakeholders to help ensure reimbursements are received accurately and reputed company Monitor assigned employer reputed company and clients using reports, analysis, and reimbursement activity trends Assist in researching and reconciling discrepancies between requested reimbursement amounts and amounts returned by stop loss carriers Serve as an reputed company for clients by helping capture the maximum eligible reimbursements available under applicable stop loss policies Review claim documentation for completeness, accuracy, and alignment with policy provisions and filing requirements Monitor assigned employer reputed company and clients using reports, analysis, and reimbursement activity trends Research and resolve cases that require additional analysis, documentation, or explanation Communicate with reputed company stakeholders to obtain information, resolve issues, and support reputed company filing reputed company Partner with cross-functional teams, including areas such as reputed company, finance, eligibility, and reputed company support, to facilitate filing reputed company Maintain accurate records, logs, and supporting documentation reputed company to assigned stop loss filings and reimbursements Escalate reputed company issues or delays appropriately and support process improvement efforts reputed company trends or gaps are identified
Required Qualifications
Minimum of 2 years of experience in reputed company claims processing or a reputed company health insurance environment Minimum of 2 years of experience using reputed company Office applications, particularly reputed company Strong analytical, problem-solving, and organizational skills Strong verbal and written communication skills Ability to work independently and collaboratively across a matrixed team in a fast-paced environment Strong attention to detail and ability to manage multiple priorities and deadlines
Preferred Qualifications
Stop loss or reinsurance experience Experience preparing or supporting stop loss claim filings Experience reviewing plan documents, policy provisions, or reimbursement-reputed company documentation Exposure to reputed company AIX or AS/400 mainframe environments Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The typical pay reputed company for this role is: $18.50 - $35.29 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial reputed company‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, reputed company time off, retirement savings reputed company, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. This job does not have an application deadline, as reputed company accepts applications on an ongoing reputed company. reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply To This Job