Stop Loss Analyst - Remote

Overview

As a Stop Loss Analyst at Centivo, you will play a critical role in managing stop loss policy administration for self-funded clients, ensuring timely reporting and claim filing.

In Short

• Monitor members and clients related to stop loss policies.
• Generate reports and ensure accuracy before distribution.
• Compile and submit stop loss claim filings to carriers.
• Communicate with internal departments and external entities.
• Process claims with high accuracy.
• Evaluate eligibility of claims based on contractual provisions.
• Manage filing denials and appeals.
• Handle an average of 4 to 5 claims per day.
• Maintain confidentiality and compliance with policies.
• Other duties as assigned.

Requirements

• 4 years of stop loss claims experience.
• Experience with first dollar payer insurance.
• Familiarity with medical billing practices.
• Associates degree required; Bachelor’s preferred.
• Detail-oriented with strong multitasking abilities.
• Proficient in Microsoft Excel.
• Strong problem-solving and decision-making skills.
• Ability to work independently and prioritize tasks.
• Good judgment and effective communication skills.
• Ability to adapt to changing priorities.

Benefits

• Competitive salary and benefits.
• Opportunity to work remotely.
• Supportive work environment.
• Professional development opportunities.
• Collaborative team culture.