Nashville, Tennessee, United States · On-site
About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that ena…
Skills: Stop loss claims, TPA operations, Self-funded health plans, Data analytics, Excel
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The Stop Loss Analyst manages financial risk by evaluating large medical and pharmacy claims for stop loss reimbursement eligibility. They also collaborate with internal departments and carriers to ensure accurate submissions and resolve claim issues.
Candidates should have at least 2 years of experience in stop loss claims or TPA operations and a strong understanding of self-funded health plans. A bachelor's degree in a relevant field is preferred, along with advanced Excel skills and attention to detail.
About Lucent Health
Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers.
We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health.
Honest
Ethical
Hardworking
Summary
The Stop Loss Analyst plays a pivotal role in managing financial risk associated with self-funded health plans. This position supports the underwriting and claims processes by evaluating large claims, tracking stop loss reimbursement trends, and ensuring accurate and timely submissions. Ideal candidates will combine analytical rigor with industry knowledge to protect the TPA and its clients from catastrophic claims exposure.
Equal Employment Opportunity Policy Statement
Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.
Data Driven + Human Focused
As one of the nation’s largest independent TPAs, Lucent Health delivers vertically integrated health solutions, including plan administration, concierge care, pharmacy, and care management. Lucent Health’s advanced analytics provide transparency into health plan spend and actionable insights that deliver industry-leading member engagement, lower medical cost trend, and fewer large claims.
Offices: 211 Commerce Street, Suite 601, Nashville, TN 37201, US
Data Driven + Human Focused
As one of the nation’s largest independent TPAs, Lucent Health delivers vertically integrated health solutions, including plan administration, concierge care, pharmacy, and care management. Lucent Health’s advanced analytics provide transparency into health plan spend and actionable insights that deliver industry-leading member engagement, lower medical cost trend, and fewer large claims.
Offices: 211 Commerce Street, Suite 601, Nashville, TN 37201, US
