Stop-Loss Claims Strategist

Wellnet; Feasterville-Trevose (Bucks County); On-site; USD 50,000 - 70,000; Full time

Job summary

A healthcare solutions provider in Feasterville-Trevose is seeking a Stop-Loss Coordinator responsible for managing the entire stop loss claims process for high-cost claims. The ideal candidate will have a minimum of 2 years experience in claims, strong organizational skills, and knowledge of stop loss insurance. Responsibilities include tracking claims, preparing reports, and ensuring timely resolutions. This role requires strong analytical skills and the ability to interact effectively with internal and external stakeholders.

Responsibilities

• Track reimbursement claims and support finance for accurate payment reconciliation.
• Manage the monthly stop loss ending process with appropriate notifications.
• Monitor and track total reimbursement dollars for clients and prepare reporting.
• Prepare and submit claims for advance funding to stop loss carrier.
• Research individual claim disputes and provide resolutions.

Skills

Knowledge of stop loss insurance

Strong organizational skills

Strong sense of professionalism and personal accountability

Working knowledge of Microsoft Office, particularly Excel

Alignment with core values

Education

Minimum of 2 years of claims experience

Experience with administering self-insured health plans

Job description

A healthcare solutions provider in Feasterville-Trevose is seeking a Stop-Loss Coordinator responsible for managing the entire stop loss claims process for high-cost claims. The ideal candidate will have a minimum of 2 years experience in claims, strong organizational skills, and knowledge of stop loss insurance. Responsibilities include tracking claims, preparing reports, and ensuring timely resolutions. This role requires strong analytical skills and the ability to interact effectively with internal and external stakeholders.