Stop Loss Document Specialist

Aither Health • Town of Amherst, NY

8d • $17 - $19 • Hybrid

About The Position

The Document Specialist plays a key support role in the Stop Loss submission process by gathering, organizing, and coordinating all necessary documentation to ensure timely and accurate claim submissions. This position works closely with the Stop Loss Submission Coordinator, Stop Loss Administrators, and external carriers to support efficient processing, follow-up, and appeals.

Requirements

• High school diploma or equivalent
• Minimum of 1-2 years of work experience
• Strong attention to detail and organizational skills
• Ability to manage multiple priorities and deadlines in a fast-paced environment
• Intermediate knowledge of Microsoft Excel, including formulas and data organization.
• Excellent written and verbal communication skills

Responsibilities

• Collect and organize all ancillary documents required for stop-loss claim submissions, including but not limited to medical records, EOBs, and claim histories.
• Notify the Stop Loss team once all required documentation has been gathered and the submission is ready for processing.
• Respond to carrier requests by gathering and providing any additional documentation or clarifications needed after their initial review.
• Support the Stop Loss Coordinator by obtaining all necessary information for claim appeal packages in cases of denial or partial funding.
• Maintain accurate tracking and version control of all documents to ensure compliance and timely response.
• Collaborate with internal departments (e.g., claims, case management, client services) to source missing or clarifying materials.
• Uphold data privacy standards and ensure secure handling of all protected health information (PHI).

What This Job Offers

• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 51-100 employees