Risk Management Specialist for Healthcare Benefits

4 weeks ago


Burlington, Vermont, United States Cobalt Benefits Group LLC Full time
Risk Management Specialist for Healthcare Benefits

Job Summary

We are seeking a highly skilled Risk Management Specialist to join our team at Cobalt Benefits Group LLC. As a key member of our team, you will be responsible for overseeing the stop-loss insurance process, managing claims, coordinating with vendors, and ensuring compliance with industry regulations.

Key Responsibilities

* Analyze and process stop-loss claims to ensure accurate and timely reimbursements for eligible claims exceeding specific deductibles.
* Serve as the main point of contact with excess loss vendors, facilitating data submissions and resolving inquiries efficiently.
* Monitor claims data to identify trends and opportunities for enhancing the stop-loss program, ensuring our clients receive optimal support.
* Generate comprehensive monthly and year-end aggregate claims reports for internal stakeholders and external vendors.
* Maintain adherence to regulatory requirements and best practices in all processes and documentation.
* Communicate proactively with clients regarding their stop-loss coverage and claims status, providing exceptional service and support.

Requirements

* Bachelor's degree in finance, business administration, healthcare management, or related field preferred.
* At least 3 years in healthcare claims management or stop-loss insurance, with a proven track record of success.
* Strong understanding of stop-loss insurance policies and healthcare claims processing, with familiarity in medical terminology.
* Exceptional analytical abilities, adept in data analysis and reporting tools.
* Precision and accuracy are paramount in managing claims and documentation.
* Excellent verbal and written communication skills to engage effectively with clients, vendors, and colleagues.
* Ability to manage multiple projects in a fast-paced environment, meeting deadlines with ease.

Why Work with Us

At Cobalt Benefits Group LLC, we offer a comprehensive benefits package, including competitive medical, dental, and vision insurance, company-paid Basic Life and AD&D insurance, Flexible Spending Accounts, 401(k) Retirement Plan with employer match, generous paid time off and holidays, and a culture of innovation, collaboration, and professional development.

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