Stop Loss Specialist
About The Position
Imagine360 is seeking a Stop Loss Specialist to join the team! This position coordinates the tracking, monitoring, documenting and submission of stop loss claims. This position maintains a comprehensive understanding of the plan document(s) under their scope of responsibility. Imagine360 is a health plan solution company that combines 50+ years of self-funding healthcare expertise. Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions. Imagine360 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.
Requirements
- High School Diploma or GED
- 1+ years' experience in clerical and customer service
- Knowledge of medical terminology
- Working knowledge of computers and software including but not limited to Microsoft Office products
- Proficient mathematical, 10-key and typing skills
- Demonstrated organizational skills, problem-solving, analytical skills and detail oriented
- Demonstrated ability to remain neutral and maintain confidentiality
- Strong written and oral communication skills
- Demonstrated ability to work independently, prioritize workloads multi-task and manage priorities in order to meet deadlines
Responsibilities
- Compiles and submits stop loss claims to the carrier for reimbursement.
- Enters appropriate stop loss claims into designated database.
- Identifies, researches, and resolves stop loss carrier questions.
- Facilitates advancement funding with Finance Department.
- Complies with reporting and documentations requirements.
- Manages large case notifications process.
- Acts as a role model in demonstrating the core values in customer service delivery.
- Provides timely and thorough follow up with internal and external customers.
- Appropriately escalates difficult issues up the chain of command.
- Trains new employees as assigned.
- Serves on committees, work groups, and/or process improvement teams, as assigned, to assist in improving customer satisfaction.
- Recognizes, documents, and alerts appropriate supervisor of trends.
- Performs self-quality monitoring in order to develop and execute plans to meet established goals.
- Provides ongoing feedback to help optimize quality performance.
- Collaborates with others and cross-departmentally to improve or streamline procedures.
- Develops new or improves current internal processes to improve quality.
Benefits
- Multiple Health plan options
- Company paid employee premiums for disability and life insurance
- Parental Leave Policy
- 20 days PTO to start
- 10 Paid Holidays
- Tuition reimbursement
- 401k Company contribution
- Company paid Short & Long term Disability plus Life Insurance
- Professional development initiatives / continuous learning opportunities
- Opportunities to participate in and support the company's diversity and inclusion initiatives
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
