New

Stop Loss Claims Analyst

TEKsystems
$28.00 - $32.00 / hr
life insurance, sick time, 401(k), retirement plan

Jan 22, 2025
Description: Stop Loss Claims Analyst is a professional who specializes in managing and analyzing health insurance claims, particularly those that exceed a certain threshold, known as "stop loss" claims. Here are some key responsibilities and aspects of the role: Review, analyze, manage and adjudicate claims on all applicable lines of business to determine action to be taken * Research and resolves claim issues by identifying and analyzing problems and/or risks, and assembling the documentation needed to support the recommendation to resolve the problem * Maintain applicable logs, and files Claims Review and Evaluation: They review and evaluate health insurance claims to ensure they are processed accurately and efficiently. This involves working closely with insurance companies, healthcare providers, and employers Risk Management: They play a critical role in identifying and mitigating potential risks associated with high-cost claims. This helps in protecting employers from unexpected financial burdens1. Data Analysis: They use data analysis and predictive modeling to forecast potential claims and develop strategies to manage them. This helps in reducing costs and improving outcomes1. Regulatory Compliance: They ensure that all claims are processed in compliance with healthcare regulations and insurance policies Communication: Effective communication with stakeholders, including insurance companies, healthcare providers, and employers, is essential to resolve any issues and implement cost-saving strategies Pay and Benefits The pay range for this position is $28.00 - $32.00 Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a hybrid position in Oakbrook Terrace,IL. Application Deadline This position will be accepting applications until Jan 25, 2025. About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.