High Dollar Medical Claims Coordinator

2 months ago


Fitchburg, United States Auxiant Full time

Be part of a growing and prospering company as a High Dollar Medical Claims Coordinator for our Madison, WI office. Auxiant is a third party administrator of self-funded employee benefit plans with offices in Cedar Rapids, IA, Madison and Milwaukee, WI. Auxiant is a fast-growing, progressive company offering an excellent wage and benefit package.

**Job Summary**: Operate at the center of the organization with daily responsibilities to monitor, audit, and file stop loss insurance claims on behalf of customer contracts.

**Essential Functions**:

- Review weekly reports to identify stop loss cases
- Submit potential loss notices to stop loss carriers for members over 50% of the specific deductible
- Prepare and file stop loss claims to the stop loss carriers
- Assemble and submit additional information to carriers as requested
- Audit files at contract year-end
- Request work status information from group contact
- Monitor account balances for groups with aggregate only coverage
- Review high dollar claims to see if they need to be split
- Record data as it pertains to stop loss submissions
- Process funding received from stop loss carrier
- Run, review, and post month-end reports

**Non-Essential Functions**:

- Other duties as assigned or appropriate

**Education/Qualifications**:

- Excellent written/verbal communication skills to include the ability to interact professionally with diverse group of vendors, managers, customers and employees
- Excellent time management and organizational skills
- Strong aptitude for analytical thinking and comprehension of complex concepts
- Database / MS Access experience a plus
- Basic accounting skills
- Some College and 1-2 years related experience; or equivalent combination of education and experience.

*Full benefits including: Medical,Dental, Vision, Flexible Spending, Gym Membership Reimbursement, Life Insurance, LTD, STD, 401K, 3 weeks vacation, 9 paid holidays, casual dress code and more

Pay: From $1.00 per hour

Expected hours: 40 per week

**Benefits**:

- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance

Weekly day range:

- Monday to Friday

Ability to Relocate:

- Fitchburg, WI 53713: Relocate before starting work (required)

Work Location: In person



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