STOP LOSS ANALYST

Soluta, Inc.; Austin, Northern (TX, KY); Hybrid; USD 28,000 - 36,000; Full time

Job summary

Soluta, Inc. is seeking a Stop Loss Analyst for a fully remote role with a corporate anchor in Austin, TX.

The analyst will ensure timely reporting and filing of stop loss claims with carriers, monitor member and aggregate metrics, and prepare necessary documentation for reimbursement. Responsibilities include compiling filings, coordinating with internal teams and external partners, and handling denials and appeals to maximize client recoveries.

Responsibilities

• Prepare and file stop loss claims with carriers to maximize reimbursement.
• Generate and review reporting for accuracy before distribution to internal and external stakeholders.
• Gather supporting documentation from internal teams, vendors, clients and carriers.
• Manage filings through reimbursement, accounting for policy filing limitations.
• Communicate with departments, vendors, clients and carriers on a regular basis.
• Validate filing denials and prepare appeals when needed to maximize recoveries.

Job description

# STOP LOSS ANALYSTFully Remote • Corporate Austin - Austin, TX 78729## OverviewSalary Range$20.00 - $26.00 Hourly## DescriptionThis 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