Stop-Loss Claims Specialist

Wellnet Enerji; Of; On-site; TRY 2,934,000 - 3,667,000; Full time

Job summary

Wellnet Enerji is seeking a Stop-Loss Coordinator to manage end-to-end stop-loss claims, coordinate with carriers, and support financial reconciliation. The role requires careful claims handling, timely reporting, and collaboration with internal teams to mitigate risk.

Candidates should have at least 2 years of claims experience, especially with self-insured health plans, and strong Excel/Office skills. This is an on-site position located in Turkey, Trabzon, Of, with a focus on accuracy and

Qualifications

• Minimum of 2 years of claims experience.
• Experience with administering self-insured health plans.

Responsibilities

• Submit stoploss claims for high-cost claims and plans to carriers.
• Track reimbursement claims and support finance for accurate payment reconciliation.
• Manage monthly stop loss ending process and notify interdepartmental teams, clients or brokers.
• Prepare and submit claims for advance funding or reimbursement to the stop loss carrier.
• Research claim disputes and provide resolution.
• Interact with large case management and providers to secure patient prognosis and treatment plans.
• Discuss opportunities with Account Managers to avert risk.
• Oversee end-to-end stop loss claims process for timely and accurate processing.
• Review reimbursements and coordinate with Finance for payment reconciliation.
• Monitor pending submissions and respond to carrier requests for information.
• Analyze stop loss policies to ensure understanding of reimbursement requirements by Carrier.
• Maintain organized documentation of all stop loss claims.
• Analyze claims data and Carrier denials/requests for further information.
• Provide regular updates to Management regarding claim status and timelines.
• Coordinate with internal teams when information is needed.
• Other duties as assigned.

Skills

Stop loss knowledge

Organizational skills

Professional accountability

Excel

Communication skills

Core values alignment

Tools

Microsoft Excel

Microsoft Office

Job description

Wellnet Enerji is seeking a Stop-Loss Coordinator to manage end-to-end stop-loss claims, coordinate with carriers, and support financial reconciliation. The role requires careful claims handling, timely reporting, and collaboration with internal teams to mitigate risk.

Candidates should have at least 2 years of claims experience, especially with self-insured health plans, and strong Excel/Office skills. This is an on-site position located in Turkey, Trabzon, Of, with a focus on accuracy and