Stop-Loss Claims Specialist

Auxiant; Cedar Rapids (IA); On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Flexible Spending Account

Gym Membership Reimbursement

Life Insurance

Long-term Disability

Short-term Disability

401K

Paid vacation (3 weeks)

Paid holidays (9)

Casual dress code

Job summary

Auxiant in Cedar Rapids, IA is seeking a Medical Claims Coordinator to monitor, audit, and file stop loss insurance claims for various customer contracts. You will review weekly reports, submit loss notices, and prepare filings with stop loss carriers.

Ideal candidates have strong communication, organization, and analytical skills, plus proficient MS Word/Excel and basic accounting knowledge. Relevant experience with claims data and vendor coordination is valued.

Qualifications

• Excellent written/verbal communication skills to interact professionally with diverse group of vendors, managers, customers and employees
• Excellent time management and organizational skills
• Strong aptitude for analytical thinking and comprehension of complex concepts
• Proficient PC skills including e-mail, MS Word, MS Excel
• Database / MS Access experience a plus
• Basic accounting skills
• Some College and 1-2 years related experience; or equivalent combination of education and experience.

Responsibilities

• Review weekly reports to identify stop loss cases
• Submit potential loss notices to stop loss carriers for members over 50% of the specific deductible
• Prepare and file stop loss claims to the stop loss carriers
• Assemble and submit additional information to carriers as requested
• Audit files at contract year-end
• Request work status information from group contact
• Monitor account balances for groups with aggregate only coverage
• Review high dollar claims to see if they need to be split
• Record data as it pertains to stop loss submissions
• Process funding received from stop loss carrier
• Run, review, and post month-end reports
• Other duties as assigned or appropriate

Skills

Communication

Time management

Analytical thinking

MS Word

MS Excel

MS Access

Basic accounting

Education

Some College and 1-2 years related experience

Tools

MS Access

Job description

Auxiant in Cedar Rapids, IA is seeking a Medical Claims Coordinator to monitor, audit, and file stop loss insurance claims for various customer contracts. You will review weekly reports, submit loss notices, and prepare filings with stop loss carriers.

Ideal candidates have strong communication, organization, and analytical skills, plus proficient MS Word/Excel and basic accounting knowledge. Relevant experience with claims data and vendor coordination is valued.