Stop Loss Coordinator

Cobalt Benefits Group LLC • Exeter, NH

2d • $25 - $27

About The Position

In this dynamic role, you will oversee the stop-loss insurance process, manage claims, coordinate with vendors, and ensure compliance with industry regulations. Your analytical mindset and industry knowledge will directly contribute to our clients' success and satisfaction.

Requirements

• Associate’s Degree or 2+ years of relevant work experience.
• Solid experience with Microsoft Word, Excel, and Outlook.
• Javelina claims processing, stop-loss insurance, and medical terminology.
• Retiree/Direct Billing programs, and premium collection services, as well as providing customized benefit solutions to businesses nationwide.

Nice To Haves

• Analytical Mindset: Strong mathematical skills are essential for tracking claims and preparing reimbursement requests.
• Attention to Detail: You'll be responsible for managing high-cost claims, so accuracy is key.
• Highly Organized: Able to manage multiple tasks efficiently in a fast-paced environment.
• Team Player: Ability to work collaboratively across multiple departments and communicate effectively.
• Industry Knowledge: A background in accounting, medical billing, or banking is helpful, as well as familiarity with medical terminology. Experience with third-party administrators (TPAs) or health insurance carriers is strongly preferred.

Responsibilities

• Identify and report members who meet 50% or more of the specific deductible to our excess loss vendor.
• Collect and submit all required documentation to request reimbursement for claims that exceed the specific deductible.
• Review daily funding requests, track paid claims, and manage eligible claims submissions for stop-loss and advanced funding requests.
• Act as the liaison between the excess loss vendor and internal teams, providing necessary data and responding to vendor inquiries.
• Assist with monthly and year-end aggregate claim submissions, and support internal audits by providing necessary information.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree