Stop-Loss Claims & Reimbursement Specialist

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

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.