We are seeking a detail-oriented and proactive Claims Analyst to support the end-to-end processing of stop loss claims. In this role, you will assist with preparing, submitting, and tracking claims while ensuring accuracy, consistency, and timely follow-through. This is an excellent opportunity for someone who is organized, eager to learn, and excited to build expertise within a collaborative and supportive team environment.
ESSENTIAL JOB DUTIES AND RESPONSIBILITIES
• Support the end-to-end processing of stop loss claims, ensure timely submissions, and assist in tracking reimbursement statuses. • Requires attention to detail, strong communication skills, and a willingness to learn and follow established procedures with guidance from senior team members.
• Review and organize claim documents to ensure completeness and accuracy prior to submission. • Input claim data into internal exhibits and carrier portals with precision and consistency. • Submit stop loss claims (specific and aggregate) to carriers in accordance with timelines and documentation requirements. • Track claims through the reimbursement process and escalate delays or discrepancies as needed.
• Work closely with the Claims Manager and senior analysts to ensure smooth coordination of tasks and priorities. • Participate in regular team check-ins, training sessions, and coaching opportunities.
• Provide general administrative support to the broader claims team as requested. • Communicate with carrier partners to confirm receipt of claims and request status updates as needed.
• Collaborate with internal stakeholders, including Stop Loss associates, Lockton core teams and/or clients, to ensure proper documentation and follow-through.
• Respond to basic questions from team members regarding claim status, documentation needs, or process timing.
• Follow established claims workflows and contribute to quality assurance by double-checking data and documentation.
• Assist in maintaining claim logs, audit trails, and reporting documentation.
• Meets monthly Claims Exhibit deadlines for assigned book of business.
• Conducts a final policy year-end reconciliation for all policyholders, regardless of effective date.
• Communicates to Lockton Stop Loss associates once a final policy reconciliation has been completed.