Position Details

Type Not Specified

Experience entry

Exp. Years 1-3 years

Education High School Diploma/GED

Category Healthcare & Medical

About this role

This role involves managing the reconciliation of stop loss claims reimbursements, tracking denials, and ensuring accurate processing of claims in a remote office setting.

Key Responsibilities

Perform monthly audits
Review and record reimbursements
Enroll clients into electronic reimbursements
Track reimbursement denials
Prepare letters for reimbursements

Technical Overview

The position requires proficiency with Microsoft Office Suite, claims management, and reimbursement processes, with a focus on claims audit and data entry.

Ideal Candidate

The ideal candidate is an entry-level professional with 1-3 years of experience in medical claims and office administration, proficient in claims reconciliation and reimbursement processes. Strong organizational and communication skills are essential.

Must-Have Skills

1-2 years of experience in an office environment1-3 years medical claims experienceProficient with Microsoft Office SuiteExcellent verbal and written communication skillsAbility to prioritize tasksAbility to function in a high-paced environmentAttention to detailTime management skillsStrong analytical and problem-solving skills

Nice-to-Have Skills

Experience working with a TPA or insurance company

Tools & Platforms

Microsoft Office SuiteOffice software

Required Skills

Claims reconciliationReimbursementsClaims processingElectronic reimbursementsDenial trackingClaims auditMicrosoft OfficeOffice software

Hard Skills

Microsoft Office SuiteOffice softwareReimbursement processesClaims reconciliation

Soft Skills

Verbal communicationWritten communicationOrganizational skillsAttention to detailTime managementProblem-solvingAnalytical skills

Industry & Role

Industry Insurance

Job Function Claims reconciliation and reimbursement management

Keywords for Your Resume

ReimbursementsClaims reconciliationStop loss claimsElectronic reimbursementsDenial trackingClaims processingInsurance claimsClaims auditReimbursement lettersOffice environmentMicrosoft OfficeCustomer serviceData entryClaims managementReimbursement process

Deal Breakers

Lack of experience in medical claims, Inability to work remotely, No proficiency with Microsoft Office

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Stop Loss Reimbursement Specialist

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