STOP LOSS ANALYST

Bc&l Inc; Austin (TX); On-site; USD 60,000 - 85,000; Full time

Job summary

Bc&l Inc in Austin, TX is seeking a Stop Loss Analyst to support timely reporting and filing of stop loss claims with carriers. The role collaborates with internal teams and external partners to ensure accuracy and speed.

You will monitor members and policies, gather documentation, compile filings, and submit them for reimbursement. Regular communication with clients, vendors, and carriers is essential to maximize outcomes.

Responsibilities

• Works as part of the Stop Loss Team to ensure timely reporting and stop loss claim filing with carriers.
• Monitors members approaching or exceeding policy specs, including advance funding.
• Generates reporting and reviews for accuracy before internal and external distribution.
• Gathers supporting documentation from internal and external entities.
• Compiles stop loss claim filings with supporting information and submits to the carrier for reimbursement.
• Manages filings through reimbursement, considering policy filing limitations.
• Communicates regularly with departments, external vendors, clients, and carriers.
• Validates denials and prepares appeals to maximize reimbursement.

Job description

This position works as part of the Stop Loss Team to ensure timely reporting and stop loss claim filing with the various stop loss carriers.Monitors members approaching/exceeding spec, including policies with advance funding.Monitors clients approaching/exceeding aggregate, including policies with accommodation.Generates various reporting and reviews for accuracy before distribution, both internally and externally, as assigned.Gathers supporting documentation from both internal and external entities.Compiles stop loss claim filings, to include all supporting information/documentation, and submits to the stop loss carrier to maximize reimbursement.Manages filings, through reimbursement, to include consideration of policy filing limitations.Communicate regularly with various departments, external vendors, clients, and carriers.Validates filing denials and prepares appeals when necessary, to ensure our clients are receiving the maximum reimbursement allowed under the policy