Stop Loss Aggregate Analyst

Job not on LinkedIn

🕒 July 6

🥔 Idaho, Minnesota, +1 more states – Remote

🥔 Idaho – Remote ❄️ Minnesota – Remote 🤠 Texas – Remote

💵 $18 - $35 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🧐 Analyst

🚫👨‍🎓 No degree required

👻 Ghost score 24%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Prepare, update, and submit stop loss filing packages, including initial, subsequent, and year-end filings • Track claim activity and follow up with stop loss carriers and other stakeholders to ensure reimbursements are received accurately and timely • Monitor assigned employer groups and clients using reports, analysis, and reimbursement activity trends • Research and reconcile discrepancies between requested reimbursement amounts and amounts returned by stop loss carriers • Help capture maximum eligible reimbursements available under applicable stop loss policies • Review claim documentation for completeness, accuracy, and alignment with policy provisions and filing requirements • Research and resolve cases requiring additional analysis, documentation, or explanation • Communicate with internal and external stakeholders to obtain information, resolve issues, and support timely filing resolution • Partner with underwriting, finance, eligibility, and client support teams • Maintain accurate records, logs, and supporting documentation related to stop loss filings and reimbursements • Escalate complex issues or delays and support process improvement efforts

🎯 Requirements

• Minimum of 2 years of experience in healthcare claims processing or a related health insurance environment • Minimum of 2 years of experience using Microsoft Office applications, particularly Excel • Strong analytical, problem-solving, and organizational skills • Strong verbal and written communication skills • Ability to work independently and collaboratively across a matrixed team in a fast-paced environment • Strong attention to detail and ability to manage multiple priorities and deadlines • Stop loss or reinsurance experience preferred • Experience preparing or supporting stop loss claim filings preferred • Experience reviewing plan documents, policy provisions, or reimbursement-related documentation preferred • Exposure to IBM AIX or AS/400 mainframe environments preferred

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being