Stop Loss Reimbursement Specialist

POSITION SUMMARY

The Stop loss Reimbursement Specialist is responsible for the reconciliation of reimbursements of stop loss claims from stop loss carriers.  In addition, the position also oversees the functions of enrolling clients into electronic reimbursements and depositing of funds into client accounts.  Other responsibilities include the tracking of denied and reduced claim reimbursements, preparing letters for reimbursements.

ESSENTIAL FUNCTIONS

• Perform monthly audits to ensure all stop loss claims have been filed and all reimbursements have been received.
• Review and accurately record stop loss reimbursements.
• Enroll clients into electronic reimbursements.
• Track reimbursement denials.
• Prepare letters for stop loss reimbursements.
• Other duties as assigned.

EDUCATION

• High School Diploma/GED required

EXPERIENCE & SKILLS

• 1-2 years of experience in an office environment required
• 1-3 years medical claims experience required
• Experience working with a TPA or other insurance company a plus
• Proficient with Microsoft Office Suite or related software.
• Excellent verbal and written communication skills.
• Ability to prioritize tasks and to delegate them when appropriate.
• Ability to function well in a high-paced and at times stressful environment.
• Excellent organizational skills and attention to detail.
• Excellent time management skills with a proven ability to meet deadlines.
• Strong analytical and problem-solving skills.

COMPETENCIES

• Communication
• Customer Focus
• Accountability
• Functional/Technical Job Skills

PHYSICAL DEMANDS

• This is an office environment requiring extended sitting and computer work.

WORK ENVIRONMENT

• Remote

Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Compensation is not limited to base salary.  Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life & Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.

Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time.  All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process.  It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.