Responsible for submitting stop loss claims to our reinsurance carriers. Coordinates with claims and membership to obtain required supporting documentation for stop loss reimbursements. Maintains/provides status updates via reporting, logs, and the stop loss database of all outstanding submissions.
Required Work Experience:
Experience with AMMS claims processing system, membership & PFAB claims billing systems, and DB2/Easytrieve experience.
Proficiency with Microsoft Excel and Access.
Prior stop loss auditing and/or claims billing experience.
Strong knowledge and use of the Group Library.
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BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains Affirmative Action programs to promote employment opportunities for minorities, females, disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.
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Bluecross Blueshield Of South Carolina