Claims Analyst Job Listing at Kelly Services in Columbia, SC (Job ID 9440073)

Description

Job Summary:
We are seeking a highly organized and detail-oriented Stop Loss Claims Analyst to join our team. As a Stop Loss Claims Analyst, you will be responsible for submitting stop loss claim packets, tracking and monitoring claims, performing complex analysis, and ensuring accurate claim submissions. You will work closely with various departments and external stakeholders to provide exceptional customer service and support. This is a contract-to-perm position with the opportunity for growth and advancement.

Job Specifications:
- Job Type: Contract-to-Perm
- Location: Columbia SC
- Pay Rate: $22.00/hr
- Shift: Monday-Friday, 7:30am-4:00pm or 8:00am-4:30pm

Roles and Responsibilities:
- Prepare and file stop loss claim packets, including 50% and 100% stop loss claims.
- Run queries, compile eligibility data, and submit claim packets.
- Audit stop loss positions by comparing them to accumulated claims in the billing system.
- Research variances, document discrepancies, and make necessary adjustments.
- Respond to audit letters and collaborate with other departments to gather requested information.
- Track claims packet filing and MGU responses using the tracking database/log.
- Provide manual monitoring of special stop loss scenarios, ensuring accurate tracking and updates.
- Perform complex reviews of claims data and create custom reports and spreadsheets based on customer inquiries.

Qualifications & Skills:
- Bachelor's Degree in Business, Finance, or related field OR 4 years of stop loss and/or claims billing experience.
- 3 years of experience in accounting, auditing, billing, claims, membership, or finance.
- Strong analytical skills and ability to compile and analyze data.
- Excellent verbal and written communication skills.
- Strong customer service and organizational skills.
- Ability to take initiative, meet deadlines, and pay attention to detail.
- Proficiency in Microsoft Office, including Access.
- Experience with AMMS claims processing system, PFAB claims billing system, and DB2 is preferred.
- Ability to work in a typical office environment.

Opportunities:
- Contract-to-perm position with potential for growth and advancement.
- Chance to develop strong analytical and communication skills.
- Exposure to self-funded insurance programs.

Please note that strong Microsoft Office experience, analytical skills, and the ability to adjust to changes with ease are essential for this role. Billing, accounting, finance, auditing, and/or education requirements are not applicable.

As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account. In addition, employees are entitled to earn paid sick leave under the applicable state or local plan. Click here for more information on benefits and perks that may be available to you as a member of the Kelly Talent Community.

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About Kelly

Work changes everything. And at Kelly, we're obsessed with where it can take you. To us, it's about more than simply accepting your next job opportunity. It's the fuel that powers every next step of your life. It's the ripple effect that changes and improves everything for your family, your community, and the world. Which is why, here at Kelly, we are dedicated to providing you with limitless opportunities to enrich your life—just ask the 300,000 people we employ each year.

Kelly Services is proud to be an Equal Employment Opportunity and Affirmative Action employer. We welcome, value, and embrace diversity at all levels and are committed to building a team that is inclusive of a variety of backgrounds, communities, perspectives, and abilities. At Kelly, we believe that the more inclusive we are, the better services we can provide. Requests for accommodation related to our application process can be directed to Kelly's Human Resource Knowledge Center. Kelly complies with the requirements of California's state and local Fair Chance laws. A conviction does not automatically bar individuals from employment.

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