Stop Loss Claims Analyst

Berkley Accident and Health (a Berkley Company); West Hartford (CT); Remote; USD 60,000 - 90,000; Full time

Job summary

An established industry player is seeking a dedicated Claims Analyst to join their dynamic team. In this role, you will leverage your expertise in stop loss claims to review and adjudicate claims with precision. The company fosters a culture where every detail matters, and your contributions will directly impact the efficiency of claims processing. With flexible location options, including remote work, this opportunity allows you to thrive in a supportive environment that values your skills and adaptability. Join a forward-thinking organization committed to innovative risk management solutions and make a difference in the financial services sector.

Qualifications

• 5+ years of stop loss claims experience required.
• Strong analytical and decision-making skills are essential.

Responsibilities

• Review claim submissions to determine reimbursement eligibility.
• Process 5-7 claims daily with 99% accuracy.

Skills

Stop Loss Claims Experience

Medical Healthcare Claims

Mathematical Skills

Attention to Detail

Analytical Skills

Microsoft Office Proficiency

Job description

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Company Details

Berkley Accident and Health is a risk management company that designs innovative solutions to address the unique challenges of each client. With our entrepreneurial culture and a strong emphasis on analytics, we help employers better manage their risk. Our products include employer stop loss, benefit captives, provider stop loss, HMO reinsurance, and specialty accident. Our success stems from our nimble approach to risk, combined with the backing of W. R. Berkley Corporation, a Fortune 500 company.

Responsibilities

We have an opportunity for a Stop Loss Claims Analyst to join our team! You will review claim submissions to determine reimbursement eligibility.

Location is flexible, including remote options.

We value our employees with a culture that emphasizes that Everything Counts, Everyone Matters. Join us!

Key Functions

• Process 5-7 claims daily
• Maintain 99% accuracy
• Determine claim eligibility based on contractual provisions
• Review and adjudicate claims within authority limits
• Document claim decisions thoroughly
• Escalate issues as needed
• Other duties as assigned

Qualifications

• 5+ years stop loss claims experience
• Experience with medical healthcare claims and billing practices
• Mathematical skills for claims adjudication
• Attention to detail and multitasking ability
• Adaptability to changing priorities
• Strong analytical and decision-making skills
• Proficiency in Microsoft Office

Additional Details

We do not accept unsolicited resumes from external recruiting firms.

Salary depends on various factors including experience and location.

Sponsorship

Sponsorship is not offered for this role.

Job Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Finance and Sales
• Industries: Financial Services and Insurance