Senior Stop Loss Claims Analyst

Highmark Health

Multiple Locations, US
Base: $23.16 - $35.88; bonus/equity: not specified...
Stop loss claims processing
Excess risk and reinsurance claims
Client relationship management
This job reviews, evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards

Job Summary

  • This job reviews, evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards.
  • Monitors, reviews and analyzes various complex potential claims with emphasis on controlling losses through effective managed care.
  • Assists leadership with performing client performance evaluations to assess the accuracy of client reports submitted to the organization, efficiency of claim operations, and adequacy of systems and procedures.

Matching Summary

This job reviews, evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards.

Salary

Base: $23.16 - $35.88; Bonus/Equity: Not specified; Benefits: Not specified

Skills & Requirements

Must-have

  • Stop Loss claims processing
  • Excess Risk and Reinsurance claims
  • client relationship management
  • claim loss analysis
  • managed care
  • HIPAA compliance

Nice-to-have

  • streamlining processes
  • improving documentation
  • client education
  • internal staff training

Key Requirements

  • 5 years health insurance claims experience
  • 3 years 1st dollar claims processing
  • 3 years medical terminology
  • High School Diploma/GED required
  • Bachelor's degree preferred

Work Rights

Not specified

Tailored Resume

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