Stop Loss & Health Claim Analyst
$54.9k/y-$82.4k/y
4 days ago
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OnsiteFull-timeMid
Summary
Sun Life is seeking a Stop Loss & Health Claim Analyst to join their team in Milwaukee, WI. The role involves reviewing claims, interpreting contracts, and managing financial risks associated with Stop Loss claims.
About the Role
As a Stop Loss & Health Claim Analyst, you will be responsible for determining the eligibility of claims, applying contractual provisions, maintaining claim blocks, and preparing written rationales for claim decisions. You will also need to establish relationships with professional resources and ensure compliance with legal and regulatory guidelines.
About You
Required:
- Bachelor's degree preferred.
- A minimum of three to five years’ experience processing first dollar medical claims or stop loss claim processing.
- Strong written and verbal communication skills.
- Demonstrated ability to work as part of a cohesive team.
Preferred:
- Knowledge of Stop Loss Claims and Stop Loss industry.
- Demonstrated success in negotiation, persuasion, and solutions-based underwriting.
- Overall knowledge of health care industry.
- Proficiency using the Microsoft Office suite of products.
Benefits
- Generous vacation and sick time.
- Market-leading paid family, parental and adoption leave.
- Medical coverage.
- Company paid life and AD&D insurance.
- Disability programs.
- Partially paid sabbatical program.
- 401(k) employer match.
- Stock purchase options.
- Employer-funded retirement account.
Sun Life
Sun Life is a leading financial services organization dedicated to helping people achieve lifetime financial security and live healthier lives. We provide a wide range of insurance and investment products and services in key markets around the world including Canada, the United States, the United Kingdom, Hong Kong, the Philippines and Indonesia. At Sun Life, we have more than 34,000 employees and 112,900 advisors worldwide. Websites: Canada www.sunlife.ca/en/ US www.sunlife.com/us/en/ Vietnam www.sunlife.com.vn Hong Kong www.sunlife.com.hk Indonesia www.sunlife.co.id Malaysia www.sunlife.com.my Philippines www.sunlife.com.ph
Milwaukee, WI