Medical Stop Loss Claims Specialist

Job description

Job DetailsJob Location: Allied Benefit Systems - CHICAGO, IL 60606Position Type: Full TimeSalary Range: $23.00 - $24.00 HourlyJob Category: ClaimsPOSITION SUMMARY: The Stop Loss Claim Specialist (Medical Stop Loss Claims Specialist) is responsible for preparing and filing medical stop loss claims for reimbursement with stop loss carriers for individual stop loss (specific) coverage. Additional duties include following up with the various carriers to ensure reimbursements are received in time and in full. Further responsibilities include the appeals of denied and reduced claim reimbursements, along with retaining the appropriate documentation needed to support the reimbursement request. ESSENTIAL FUNCTIONS: 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. Prepare both the initial, subsequent, and year end claim fili...