Remote Stop-Loss Claims Administrator

Imagine360; United States; Remote; USD 42,000 - 56,000; Full time

Benefits offered by this job

Health plan options

Company-paid disability & life insure

Parental leave

PTO 20 days

Tuition reimbursement

401k contribution

Disability & life insurance

Professional development

Diversity & inclusion initiatives

Job summary

Imagine360 is a health plan solutions company seeking a Medical Claims Administrator to coordinate the receipt, tracking, and documenting of stop loss claims submissions in a fully remote setting.

Responsibilities include processing claims, logging notices, compiling periodic reporting, and ensuring data accuracy for third-party administrators. This role emphasizes quality, cross-department collaboration, and process improvements.

Qualifications

• High school diploma or GED required; associates degree preferred
• 2+ years in administrative and customer service roles
• Understanding of Medical Third-Party Administration, claims, and terminology is preferred

Responsibilities

• Coordinate stop loss claims submissions and enter into claims system
• Log potential claim notices and follow up with third-party administrator
• Prepare periodic reporting for stakeholders and ensure complete claim information
• Review and approve claims for funding with Finance and monitor quality trends
• Document claim files and collaborate across departments to improve processes

Skills

Organizational skills

Problem-solving

Analytical skills

Detail oriented

Education

High School Diploma or GED

Associates degree in Medical Billing and Coding

Tools

Microsoft Office

Job description

Imagine360 is a health plan solutions company seeking a Medical Claims Administrator to coordinate the receipt, tracking, and documenting of stop loss claims submissions in a fully remote setting.

Responsibilities include processing claims, logging notices, compiling periodic reporting, and ensuring data accuracy for third-party administrators. This role emphasizes quality, cross-department collaboration, and process improvements.