Supervisor, Stop Loss

2 weeks ago


Chicago, United States Allied Benefit Systems, LLC Full time
SUPERVISOR, STOP LOSS POSITION SUMMARY
The Supervisor, Stop Loss is responsible for assisting the Manager, Stop Loss with overseeing the department. Duties include auditing and tracking stop loss claim filings, reimbursements, and cash advance claims to ensure the department is running in an efficient and thorough manner. The Supervisor, Stop Loss also works closely with Stop Loss Data Specialist and Reimbursement Specialist on administrative, organizational, and auditing functions.

ESSENTIAL FUNCTIONS
  • Perform weekly audits of specific claims to ensure all claims were filed correctly and all reimbursements have been received.
  • Update and manage the stop loss tracking and specific logs to monitor the current status of members over the specific deductible.
  • Review and accurately record stop loss reimbursements.
  • Gather and prepare the data required to file Rx stop loss claims.
  • Responsible for the filing of aggregate claims and securing reimbursements.
  • Assist with making claim adjustments.
  • Organize the enrollment of new clients into the ACH reimbursement program.
  • Lead, coach, motivate and develop. Responsible for one-on-one meetings, performance appraisals, growth opportunities and attracting new talent.
  • Clearly communicate expectations, provide employees with the training, resources, and information needed to succeed.
  • Actively engage, coach, counsel and provide timely, and constructive performance feedback.

EDUCATION
  • Bachelor's degree or equivalent work experience preferred.

EXPERIENCE AND SKILLS
  • At least 5 years group health insurance/benefits experience required. Including at least 2 years supervisory experience required.
  • Must be highly proficient in the use of Microsoft Word, Excel, and Outlook and must have the ability to easily learn new computer applications.

POSITION COMPENTENCIES
  • Job Knowledge
  • Time Management
  • Accountability
  • Communication
  • Initiative
  • Customer Focus

PHYSICAL DEMANDS
  • This is a standard desk role - long periods of sitting and working on a computer are required.

WORK ENVIRONMENT:
  • Remote

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
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