Strategic Aggregate Stop-Loss Analyst

NHS Group; United States; Vor Ort; USD 42.000 - 68.000; Vollzeit

Zusammenfassung

Assured Benefits Administrators, Inc. (ABA) is seeking an Aggregate Stop Loss Specialist in the US to manage aggregate reporting for self-funded clients. You will research claims data, file reimbursements, and coordinate with carriers and internal teams to ensure accuracy and audit readiness.

The role emphasizes advanced Excel skills, strong communication, and the ability to handle multiple priorities in a fast-paced environment.

Qualifikationen

• Associate degree preferred; equivalent combination of education and experience considered.
• At least 3 years' experience as a claims examiner processing first dollar medical claims.
• Stop loss insurance knowledge required.
• Excellent written and verbal communication skills.

Aufgaben

• Coordinate and file Aggregate Reimbursements and Monthly Accommodation requests.
• Research claims data to validate thresholds, accumulators, and eligibility.
• Respond promptly to audit requests and gather supporting documentation.
• Document authorizations and denials from stop-loss carriers; track escalations.
• Maintain professional communication with internal teams, vendors, carriers, brokers, and clients.
• Operate independently to meet deadlines and maintain audit trails.
• Manage and track claim files with clear status visibility.

Kenntnisse

Advanced Excel

Strong communication

Organization

Written and verbal

Ausbildung

Associate degree preferred

High school diploma or GED

Tools

Microsoft Word

Outlook

Excel

Jobbeschreibung

Assured Benefits Administrators, Inc. (ABA) is seeking an Aggregate Stop Loss Specialist in the US to manage aggregate reporting for self-funded clients. You will research claims data, file reimbursements, and coordinate with carriers and internal teams to ensure accuracy and audit readiness.

The role emphasizes advanced Excel skills, strong communication, and the ability to handle multiple priorities in a fast-paced environment.