Stop-Loss Claims & Data Analysis Specialist

Southcarolinablues; Columbia (SC); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Health insurance

401k retirement savings plan

Paid Time Off (PTO)

On-site cafeterias and fitness centers

Education Assistance

Service Recognition

Job summary

BlueCross BlueShield of South Carolina in Columbia, SC seeks an Analyst, Stop Loss Accounting to manage stop loss claim submissions and data queries. You will file 50% and 100% packets, audit positions, research variances, and respond to audit letters while coordinating with related teams.

Requirements include a bachelor’s degree or equivalent, 3 years in accounting/audit/billing/claims, and strong analytical and communication skills; proficiency with Microsoft Office and Access is preferred.

Qualifications

• Bachelor's degree in a job-related field.
• 3 years in accounting, auditing, billing, claims, membership, or finance.
• Strong research, data analysis and communication skills.
• Proficient in Microsoft Office, especially Access.

Responsibilities

• Submit stop loss claim packets and respond to information requests.
• Audit stop loss positions by running queries and comparing to billing data.
• Research variances, document discrepancies and adjust as needed.
• Respond to audit letters and coordinate with claims, marketing, and managed care.
• Track filing and responses in the tracking database/log.
• Monitor special stop loss scenarios and update member positions.
• Create custom reports and spreadsheets for customer inquiries.

Skills

Accounting

Auditing

Billing

Data analysis

Customer service

Deadline-driven

Education

Bachelor's degree in related field

Degree equivalency: 4 years related work experience or Associate's + 2 years

Tools

Microsoft Office

Access

Job description

BlueCross BlueShield of South Carolina in Columbia, SC seeks an Analyst, Stop Loss Accounting to manage stop loss claim submissions and data queries. You will file 50% and 100% packets, audit positions, research variances, and respond to audit letters while coordinating with related teams.

Requirements include a bachelor’s degree or equivalent, 3 years in accounting/audit/billing/claims, and strong analytical and communication skills; proficiency with Microsoft Office and Access is preferred.