Stop Loss Claims Specialist I-Aggregate
$47,840–$49,920 year
Remote · Chicago, Illinois, United States
Job Summary
Stop Loss Claims Specialist I-Aggregate is responsible for preparing and filing medical stop loss claims for reimbursement with stop loss carriers for aggregate coverage. Duties include following up with carriers to ensure reimbursements are received in time and in full, appealing denied or reduced reimbursements, auditing aggregate positions, tracking funding balances, and preparing monthly and year-end accommodation aggregate claim filings. The role requires understanding stop loss policy provisions and client SPD documentation, communicating with internal departments and external partners, and leveraging Excel for analysis. Remote-friendly with a Chicago, IL presence option; strong emphasis on time management, attention to detail, and collaboration with brokers, reinsurance carriers, and clients.
Required Qualifications
- 1 to 2 years of claims experience in a self funded environment
- thorough knowledge of Stop Loss terminologies, concepts, and catastrophic claim handling
- interpret Stop Loss contracts and Client summary Plan Descriptions (SPD)
- Stop loss filing experience preferred
- Accounting or Finance background a plus
- 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
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