Stop Loss Claims Examiner

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