STOP LOSS ANALYST

This position works as part of the Stop Loss Team to ensure timely reporting and stop loss claim filing with the various stop loss carriers.

Monitors members approaching/exceeding spec, including policies with advance funding.

Monitors clients approaching/exceeding aggregate, including policies with accommodation.

Generates various reporting and reviews for accuracy before distribution, both internally and externally, as assigned.

Gathers supporting documentation from both internal and external entities.

Compiles stop loss claim filings, to include all supporting information/documentation, and submits to the stop loss carrier to maximize reimbursement.

Manages filings, through reimbursement, to include consideration of policy filing limitations.

Communicate regularly with various departments, external vendors, clients, and carriers.

Validates filing denials and prepares appeals when necessary, to ensure our clients are receiving the maximum reimbursement allowed under the policy