Stop Loss Coordinator

BlueCross BlueShield of South Carolina•San Francisco, CA

About The Position

Provides reinsurance support for new and renewal business, underwriting, claims audit/record keeping and/or other functions. May perform calculations and process general accounting requests for billing or payments, and/or check the status of claims and process policy changes. Provides customer service clients and partners. Runs reports as needed.

Requirements

High School Diploma or equivalent.
1 year customer service or administrative experience.
Excellent verbal and written communication skills.
Good human relations skills.
Strong research ability.
Ability to function in a high-pressure environment with minimum supervision.
Ability to handle confidential or sensitive information with discretion.
Strong organizational skills.
Proven customer service skills.
Good judgment.
Proficient spelling, punctuation, grammar, and basic math skills.
Microsoft Office.

Nice To Haves

Associate Degree-Business Administration or related field.
2 years-customer service, operations support, or underwriting support.

Responsibilities

Processes mail, email and faxes to maintain departmental productivity, quality and timeliness standards.
May assist in preparing various financial data associated with refunds, recoupments, adjustments, and reissues, and ensure appropriate documentation for each refund request and associated payment.
Maintains logs.
Assists in processing/providing routine premium billing statements and/or various reports.
Maintains filing systems.
Coordinates communication of information between reinsurance companies and various internal and external areas.
Reviews documentation for completeness, and may rate new business, order required reports within timeliness standards, determine benefits, issue new policies, and/or report surplus lines taxes.
Requests additional information when needed within timeline standards.
Accurately documents process changes.
Checks status of claims or notices, and may service existing accounts by processing endorsements/amendments, identifying problems, and responding to inquiries.
May review disbursement requests for large case management claims and other specific diagnosis codes, and forward to claims for detailed review.
Ensures effective customer relations by responding accurately, timely, and courteously to telephone or written customer inquiries.
Accurately documents inquiries.