Stop Loss Aggregate Analyst
Core
Prepare, track, reconcile, and submit stop loss claim filings for self-funded employer groups to ensure accurate and timely reimbursements from carriers.
Role type
Claims analyst (stop loss/reinsurance)
Builds
Stop loss claim filings and reimbursement reports
Domain
Health insurance / Claims administration
Deliverable
client delivery
Required skills
Stop loss claims processing, Microsoft Excel, data analysis, policy review, stakeholder communication, record maintenance
Preferred skills
Reinsurance experience, mainframe environment exposure (IBM AIX/AS/400)
Responsibilities
Prepare and submit stop loss filing packages; track claim activity and follow up with carriers; monitor employer groups using reports and trends; research and reconcile reimbursement discrepancies; review claim documentation for accuracy and policy alignment; communicate with internal and external stakeholders to resolve issues.
Seniority
Mid-level, hands-on IC