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Job Description: S top-loss Job Tasks This position is responsible for thorough evaluation of all submitted claims to ensure appropriate reimbursement of Stop Loss claims. Responsibilities: -Analyzing claims to ensure all necessary documentation has been received and criteria are met for reimbursement, including evaluation of appropriate billing, member eligibility, contracts and plan specifications. -Coordinating with various departments to ensure that all cost containment initiatives are executed, and appropriate case management is engaged. -Initiating claim reimbursement to self-funded... more ->