001 Blue Cross And Blue Shield Of South Carolina

Senior Stoploss Claim Auditor

W@H Minnesotaremotesenior

Posted yesterday · via Workday

See if I'm a fit →Tailor my resume for this role →Apply on Workday ↗

About this role

Summary Description Position Purpose: Audit and authorize reimbursement of specific and/or aggregate medical stop loss claims. Effectively mitigate client medical stop loss claims and provide excellent customer service. Logistics: iiSi | Writing Medical Stop Loss Across the Nation – one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is full-time (40 hours/week) Monday-Friday from 8:00am-5:00pm EST and will be fully remote. What You’ll Do: Analyze and adjudicate stop loss claims and request appropriate reimbursement from carrier. Recognize cost mitigation opportunities. Authorize and release stop loss claims reimbursement checks at or below pre-set authority limits. Initiate claims investigations and vendor referrals.…

Read the full description on 001 Blue Cross And Blue Shield Of South Carolina's site →

What we'd score you on

reqspace match rubric

Five dimensions, recruiter-grade. Upload your resume and we'll generate a written explanation of where you fit and where the gaps are.

Skills match

We compare your skills against the role requirements.

Level fit

This role is senior-level. We check your trajectory against it.

Domain experience

Your work in the role's domain matters more than your years total. We weight recent and direct experience.

Recency

A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.

Location fit

This role is remote-eligible — we factor in your stated location and time-zone overlap.

Score yourself on this role.

Free · no card · written explanation included

See if I'm a fit →

More at 001 Blue Cross And Blue Shield Of South Carolina

See all open jobs at 001 Blue Cross And Blue Shield Of South Carolina →