Reinsurance Specialist - Medical Stop Loss Claims


Brookline, MA

Industry: Business Services


Less than 5 years

Posted 261 days ago

  by    Mason Ingling

This job is no longer available.

Assist filing stop loss claims and securing related reimbursements from stop loss carriers as part of group health benefit administration division, to include communicating with clients, brokers, carriers, and internal departments; filing initial and follow-up information; and processing client funding and reimbursements.




*** Develop improvements to stop loss processes in a medical, group health, or self-funded insurance setting.


*** Submit stop loss claims in excess of specific deductible to reinsurance carriers for reimbursement and Potential High Dollar Claimant and Large Claims notifications to track high dollar claimants for stop loss and underwriting purposes.


*** Follow-up, apply, and send reimbursements and appeal denied or pended reimbursements.


*** Prepare reinsurance reporting and notifications to clients, carriers, and brokers.


*** Prepare aggregate claim filings and documentation for claim audits.


*** Send policy year-end communications to clients on potential Aggregate and funding claims requirements.


Opportunity comes with an industry competitive pay, medical, dental & vision benefits, employee assistance programs, tuition reimbursement, generous paid time off, 401(k) plan with company match, equity options, and more!

Please reference #37706104 when responding.Education Requirements: Bachelor DegreeMinimum Experience Requirements: 2-5 yearsJob City Location: BrooklineJob State Location: MAJob Country Location: USA

$80K - $110K