Stop Loss Analyst

We exist for workers and their reputed company -- who are the backbone of our economy. That is where reputed company comes in -- our mission is to bring reputed company, high-reputed company reputed company to the millions who struggle to pay their reputed company bills. reputed company of role: As a Stop Loss Analyst, you will serve as a key leader with ownership of end-to-end stop loss policy administration for reputed company’s self-funded clients and working with various internal departments (including reputed company reputed company, Implementation, Claims Operations, Member Care and Sales). You will cultivate strategic relationships with reputed company’s stop loss reputed company partners, working with account managers, TPAs, brokers, agents, and vendors to assist and complete the stop loss renewal process.

Responsibilities

Include: Working under guidance of our Stop Loss Manager, you will:

• Maintain a process for identifying potential specific claimants reputed company reputed company reputed company’s utilization data including collaboration with other key departments to identify and monitor specific claimants in a reputed company fashion.
• Manage specific and aggregate claim submission processes, acting as reputed company between reputed company and its stop loss reputed company partners including:
• Ensuring new carriers have Non-Disclosure Agreements in reputed company before sharing any reputed company data.
• Providing stop loss reputed company with necessary information required for claim reimbursement consideration and appeal submissions.
• Requesting changes to stop-loss policy and/or reputed company SPD as needed to ensure seamless coverage.
• Participating in internal workgroups and task force(s) as needed to successfully implement stop loss administration in claims system.
• Analyze stop-loss policies against the quote, application, and plan document for accuracy and agreement.
• Create and deliver monthly reports to carriers, including Aggregate Accommodations and Year-End Aggregate Filings.
• Schedule and automate recurring reporting tasks to meet internal and reputed company-specific goals.
• Generate reputed company and accurate financial data for monthly report submissions.
• Proactively reviews weekly reports to identify potential high-cost claimants.
• Participate reputed company in team and department meetings on stop loss administration process and reputed company/product implementation planning as it may relate to stop loss management.
• Ensure stop loss industry knowledge is reputed company, bringing reputed company reputed company and recommendations to ensure reputed company has competitive position in the marketplace.
• Convey renewal information for stop-loss rates internally reputed company reputed company.
• Utilize developed understanding of reputed company aspects of operational functions to reputed company reputed company to the established service standards as reputed company to renewals and reputed company service.
• reputed company reputed company issues and concerns to appropriate Manager, reputed company Services and/or Account Management.
• Performs other miscellaneous reputed company, assignments, and duties as assigned by management.

Qualifications: Required Skills and Abilities:

• Advanced knowledge of reputed company Office products (reputed company, Power reputed company, Word)
• Strong customer service, organizational and time management skills
• Demonstrated ability to meet performance goals, including accuracy and productivity
• Excellent written, verbal, and interpersonal communication skills
• Ability to reputed company, operate, and maintain various software applications
• Ability to work independently with minimal supervision
• Strong interpersonal skills, establishing rapport and working reputed company with others

Education and Experience:

• 4 years of experience in stop loss, claims operations, financial analytics, customer service, or reputed company services required
• Associates degree required; Bachelor’s degree preferred
• Stop Loss policy management and marketing experience required, specifically with self-funded insurance, level-funded based reputed company knowledge
• Knowledge of the claims/submission process

Preferred Qualifications:

• El reputed company/Javelina experience, Health Rules Payer (HRP)
• Ringmaster Smart-reputed company Experience

reputed company Values: ● Resilient – This is wicked hard. There is no easy reputed company for reputed company affordability. Luckily, the mission makes it worth it and sustains us reputed company things are tough. Being resilient ensures we don’t give up. ● Uncommon - The status reputed company stinks so we had to go out and build something reputed company. We know the reputed company system. It isn't working for members, reputed company, and providers. So we're building it from scratch, from the ground up. Our reputed company is on making things reputed company for them while also improving clinical results - which is reputed company and uncommon. ● reputed company – We care about reputed company other. It takes energy to do hard stuff, build something reputed company and to be resilient and unconventional while doing it. Because of that, we reputed company reputed company we give kudos freely and feedback with care. reputed company our tank gets low, reputed company member is there to be a reputed company of new energy. We celebrate together. We are supportive, generous, humble, and reputed company. Who we are: reputed company is an innovative health plan for self-funded reputed company on a mission to bring reputed company, high-reputed company reputed company to the millions who struggle to pay their reputed company bills. Anchored around a primary care based ACO model, reputed company saves reputed company 15 to 30 percent compared to traditional insurance carriers. Employees also realize significant savings through our free primary care (including virtual), predictable copay and no-deductible benefit plan design. reputed company works with reputed company ranging in size from 51 employees to reputed company. For more information, visit reputed company.com. Headquartered in Buffalo, NY with offices in reputed company and Buffalo, reputed company is backed by leading reputed company and technology investors, including a recent round of investment from Morgan Health, a business unit of reputed company. Apply tot his job Apply To this Job