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A new kind of healthcare company committed to restoring affordability for American workers and their employers
Stop Loss Analyst
Location
United States
Posted
97 days ago
Salary
$65K - $70K / year
Seniority
Senior
Job Description
Stop Loss Analyst
Centivo
• Maintain a process for identifying potential specific claimants within each client’s utilization data • Manage specific and aggregate claim submission processes, acting as liaison between Centivo and its stop loss carrier partners • Ensure new carriers have Non-Disclosure Agreements in place before sharing any client data • Provide stop loss carrier with necessary information required for claim reimbursement consideration and appeal submissions • Request changes to stop-loss policy and/or client SPD as needed to ensure seamless coverage • Participate 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 carrier-specific goals • Generate timely and accurate financial data for monthly report submissions • Proactively reviews weekly reports to identify potential high-cost claimants • Participate actively in team and department meetings on stop loss administration process and client/product implementation planning • Ensure stop loss industry knowledge is current, bringing forward ideas and recommendations to ensure Centivo has competitive position in the marketplace • Convey renewal information for stop-loss rates internally within Centivo • Utilize developed understanding of all aspects of operational functions to efficiently perform to the established service standards as related to renewals and client service • Elevate client issues and concerns to appropriate Manager, Client Services and/or Account Management • Performs other miscellaneous projects, assignments, and duties as assigned by management
Job Requirements
- 4 years of experience in stop loss, claims operations, financial analytics, customer service, or client 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 client knowledge
- Knowledge of the claims/submission process
- Advanced knowledge of Microsoft Office products (Excel, Power Point, 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 access, operate, and maintain various software applications
- Ability to work independently with minimal supervision
- Strong interpersonal skills, establishing rapport and working well with others
Benefits
- Offers Equity
- Offers Bonus
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