Principal Duties and Responsibilities : Work closely with our reinsurance carriers externally, as well as the Claim's Department internally, to ensure all claims eligible for stop loss reimbursement are received, reported and processed timely. Provides updates to internal teams, vendors and clients as needed. Complete and file appropriate documentation to reinsurance carriers for specific and aggregate claims. This includes but is not limited to 50% notifications, claim reimbursements, additional information as requested by the carrier, etc. File stop loss reimbursement claims for assigned clients according to the requirements of each stop loss contract. Monitor reimbursements from stop loss carrier. Work with general underwriters, carriers and clients to resolve any issues regarding stop loss reimbursement. Updates current spreadsheet of filed and outstanding reinsurance claims as well as denied claims. Creates, maintains, and distributes weekly and monthly reporting to the CFO, Claims Director and Client Relations Consultants (per assigned client). Requirements : High School Education required; some college preferred. 1 year experience working with Reinsurance Carriers. 1 year experience handling stop loss claims. 3 years' experience in the Healthcare claims industry. 1 year experience working in a TPA environment. Preferred Skills : Must be able to perform data entry operations quickly and accurately. Strong computer skills, including Word, Excel, Outlook, and Claims Systems. Basic understanding of accounting procedures. ICD-10 and CPT code experience. Must be highly organized and detail oriented. Excellent written and verbal communication skills.

Principal Duties and Responsibilities : Work closely with our reinsurance carriers externally, as well as the Claim's Department internally, to ensure all claims eligible for stop loss reimbursement are received, reported and processed timely. Provides updates to internal teams, vendors and clients as needed. Complete and file appropriate documentation to reinsurance carriers for specific and aggregate claims. This includes but is not limited to 50% notifications, claim reimbursements, additional information as requested by the carrier, etc. File stop loss reimbursement claims for assigned clients according to the requirements of each stop loss contract. Monitor reimbursements from stop loss carrier. Work with general underwriters, carriers and clients to resolve any issues regarding stop loss reimbursement. Updates current spreadsheet of filed and outstanding reinsurance claims as well as denied claims. Creates, maintains, and distributes weekly and monthly reporting to the CFO, Claims Director and Client Relations Consultants (per assigned client). Requirements : High School Education required; some college preferred. 1 year experience working with Reinsurance Carriers. 1 year experience handling stop loss claims. 3 years' experience in the Healthcare claims industry. 1 year experience working in a TPA environment. Preferred Skills : Must be able to perform data entry operations quickly and accurately. Strong computer skills, including Word, Excel, Outlook, and Claims Systems. Basic understanding of accounting procedures. ICD-10 and CPT code experience. Must be highly organized and detail oriented. Excellent written and verbal communication skills.

Nearest Major Market: Decatur
Job Segment: Data Entry, Administrative