Stop Loss Claims Examiner

Job Summary

A company is looking for a Stop Loss Examiner.

Key Responsibilities

• Manage a block of business and audit Stop Loss claims according to policy provisions
• Adjudicate claim reimbursements within specified turnaround times and maintain quality standards
• Provide support for peers and manage pending claim files with consistent follow-up and documentation

Required Qualifications

• High School diploma or equivalent experience required
• Strong analytical and contract interpretation skills
• Ability to work with deadlines and adapt to a changing environment
• Proficient in PC use
• Entry-level position; prior experience in claims is beneficial but not required