[Remote] Stop Loss Claims Specialist I-Aggregate

Remote Full-time
Note: The job is a remote job and is open to candidates in USA. Allied Benefit Systems is a company that focuses on claims management and insurance solutions. They are seeking a Stop Loss Claims Specialist I-Aggregate who will be responsible for preparing and filing medical stop loss claims for reimbursement with carriers, as well as following up to ensure timely reimbursements and handling appeals for denied claims. Responsibilities Compile and submit claim reports and the necessary documentation to file a stop loss claim Frequently monitor the status of claims assigned and follow up with stop loss carriers Strong ability to answer questions and requests from stop loss carriers for additional information promptly and with thorough information in support of claim reimbursement Communicate with other internal departments to resolve claim issues Ability to manage time to file aggregate accommodation, level funded and/or final claim submissions per contract stipulations Appeal the denials or reduction of reimbursements by the stop loss carrier Responsible for auditing the aggregate positions, tracking the funding balance and updated reporting monthly Prepare both the year end and monthly accommodation aggregate claim filings upon reconciliation of the claim activity Understand stop loss policy provisions, as well as group plan documentation in support of claim reimbursements Ability to adapt to new concepts and systems Other duties as assigned Skills High School diploma or equivalent required 1-2 years of claims experience in a self-funded environment Have a thorough knowledge of Stop Loss terminologies, concepts, and catastrophic claim handling Ability to interpret Stop Loss contracts and Client summary Plan Descriptions (SPD) Proficient with Microsoft Office Suite, specifically with Microsoft Excel Strong analytical and problem-solving skills Excellent verbal and written communication skills Demonstrated elevated level of organizational skills and superior attention to detail Excellent time management skills with a proven ability to meet deadlines Demonstrated ability in developing and maintaining positive relationships with team members, internal departments, various brokers, reinsurance carriers, and clients Some college or equivalent work experience preferred Stop loss filing experience preferred Accounting or Finance background a plus Benefits Medical Dental Vision Life and Disability Insurance Generous Paid Time Off Tuition Reimbursement EAP Technology Stipend Company Overview Allied offers insurance products, self-insurance solutions, custom insurance and healthcare solutions to the individuals and organizations. It was founded in 1980, and is headquartered in Chicago, Illinois, USA, with a workforce of 501-1000 employees. Its website is
Apply Now

Similar Opportunities

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote Full-time

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote Full-time

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote Full-time

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote Full-time

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote Full-time

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote Full-time

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote Full-time

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote Full-time

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote Full-time

USPS Office Helper

Remote Full-time

Customer Support Associate- Japanese Speaker

Remote Full-time

Senior/Principal RD Mechanical Engineer - Advanced Fuzing Technology, Remote

Remote Full-time

Senior Application Developer- IDCS (M)

Remote Full-time

Project Assistant (SG-25) Item# 06475

Remote Full-time

Experienced Remote Customer Support Specialist – Airline Industry Leader in Customer Experience and Innovation

Remote Full-time

**Experienced Remote Data Entry Clerk – No Experience Required, Competitive Salary, Work from Home Opportunity**

Remote Full-time

Community Manager, Central Coast South

Remote Full-time

Accounts Receivable Specialist

Remote Full-time

Ship Operations Manager; Radar, Naval Vessel-Remote

Remote Full-time

**Experienced Entry-Level Remote Data Entry Specialist – Thriving in a Dynamic and Inclusive Work Environment at blithequark**

Remote Full-time
← Back to Home