Job description

HealthComp is hiring an Insurance Claims Specialist, who has at least 1 year of experience handling healthcare claims, to join our Stop Loss Team. In this role, your will support the insurance claim and reimbursement process. This is an amazing opportunity to learn more about the health care industry and advance your career with a rapidly expanding organization!

RESPONSIBILITIES

• Prepare Stop Loss claims and applicable documents to determine stop loss filing eligibility applicable to the excess loss policy
• Files submissions of spec claimants (running reports, gathering necessary documents and email correspondence), processing all submissions within established internal timeframes
• Coordinate advanced funding requests, with the client and their stop loss carrier
• Creates initial specific file for each claimant and files all submissions in our EDOCS platform
• Coordinates the release of “on hold” claims
• Acts as the liaison between the PBM’s and internal clients, as it pertains to our stop Loss claimants
• Keeps immediate supervisor apprised of open or disputed items
• Contributes to daily workflow with regular and punctual attendance
• Generates weekly outstanding reimbursement report and follows up with the Stop Loss carrier

REQUIREMENTS

• Experience processing stop loss and/or health insurance claims
• Knowledge of medical terminology, CPT, HCPCS and ICD-10 codes
• Strong written and verbal communication skills
• Proficient in Word, Excel, and outlook
• Ability to organize, prioritize, and multitask in a fast-paced environment
• Demonstrate ability to work independently with excellent judgment
• A detail-oriented, analytical, financially minded approach

BENEFITS:

• Paid time off policy to support a healthy work-life environment
• Full offering of health and wellness benefits for you and your family
• Company paid life insurance and disability plan
• 401K plan with company matching

ABOUT HEALTHCOMP: Operating since 1994, we’re a third-party administrator (TPA) committed to providing employers with all the services needed to administer their benefits efficiently resulting in better health outcomes for their employees and higher cost savings for them. We partner with a variety of health providers and technology vendors to ensure a robust offering of medical, dental, vision, COBRA, HIPAA, flexible spending accounts and reference-based pricing, so members can make the most out of their benefits. It’s comprehensive care without the confusion.

Job Type: Full-time

Pay: $20.00 - $22.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Flexible spending account
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Education:

• High school or equivalent (Preferred)

Experience:

• Stop Loss Insurance: 1 year (Preferred)
• Medical Claims processing: 1 year (Required)

Work Location: One location

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