Stop Loss Claims Support
About The Position
Review complex claims and related situations, using discretion and critical thinking to make informed decisions that may require deviation from normal guidelines. Provide direction on excess risk claims and respond to claim or reporting inquiries from internal and external stakeholders. This position may be performed 100% remotely from home or at a major office location on a hybrid schedule. The role also supports the development and training of less experienced claims staff, manages claim suspense accounts and audits, contributes to process improvements and departmental or company initiatives, and performs stop-loss claims systems testing. Other duties and projects may be assigned.
Requirements
- High school diploma or GED.
- 3–5 years of claims or insurance experience.
- Knowledge of industry-related claim systems and practices.
- Proficiency in MS Excel, including macros, pivot tables, and formulas.
- Proven analytical and problem-solving skills and attention to detail.
- Demonstrated leadership skills.
- Excellent interpersonal and negotiation skills.
- Excellent written and oral communication skills.
Nice To Haves
- Bachelor’s degree preferred.
Responsibilities
- Review complex claims and situations, make informed decisions, and provide direction on excess risk claims.
- Respond to internal and external claim or reporting inquiries from managers, brokers, general agents, and administrators.
- Provide direction, develop, train, and mentor less experienced claims staff; complete audits and provide feedback.
- Manage claim suspense accounts to support accurate claim processing, appropriate financial reporting, and controls.
- Manage mid-policy period and year-end audits.
- Assist in developing and implementing process improvements.
- Participate in and/or facilitate department and company projects and special initiatives.
- Conduct stop-loss claims systems testing.
- Perform other duties and projects as assigned.
Benefits
- Health insurance
- Dental insurance
- Vision insurance
- Life insurance
- 401(k) savings plan with company matching contributions up to 6%
- Employer-paid Voya Retirement Plan cash balance benefit of 4%
- Tuition reimbursement up to $5,250 per year
- 20 days of paid time off
- Nine paid company holidays
- Flexible Diversity Celebration Day
- 40 hours of paid volunteer time per calendar year
- Incentive opportunities, including annual cash incentives, sales incentives, and/or long-term incentives, based on role and achievement of annual performance objectives
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
