Trainer Stop Loss Claims

Brown & Brown Insurance

2d•$80,000 - $100,000

About The Position

Brown & Brown is seeking a Trainer Stop Loss Claims to join their growing team. The incumbent is responsible for providing training for newly hired Specific Stop Loss claims auditors and refresher training for all Specific Stop Loss claims auditors. The company culture rewards self-starters and those committed to doing what is best for customers.

Requirements

3-5 years of Specific Stop Loss Claim experience.
Prior Team Lead or Management experience in stop loss claims to include experience with quality assurance.
Prior experience with industry repricing methodologies. (PPO, Wrap Networks, Reference Based Pricing, etc.)
Demonstrated proficiency in Microsoft Office, including Microsoft Outlook.
Demonstrated strong analytical/critical thinking skills; and detail‐oriented focus.
Strong written and verbal communication skills.
Ability to work independently with minimal supervision.

Nice To Haves

Prior experience auditing aggregate stop loss claims.
History of successful Process Improvement initiatives.
Prior experience leading a team or managing processes.

Responsibilities

Develop a training curriculum with all necessary materials/documentation, covering all aspects of specific stop loss claims including, but not limited to logging claims, preparing working copies; system line-item data entry, completing claim checklists and examining all claim details; pending and/or releasing payments, pend follow up and correspondence handling.
Establish an objective measuring tool for tracking trainee progress or lack thereof.
Train all new specific stop loss claim auditors to determine whether they have successfully completed the training program and are ready to be placed in production with their team.
Serve as a subject matter expert for and assigned claims team and provide technical guidance related to specific stop loss claims to the team.
Review and Analyze Specific Stop Loss claims referred by auditors or as requested by clients and assist with over authorization reviews.
Audit Specific Stop Loss claims during peak periods.
Ensure continuous process improvement opportunities are reviewed and implemented, as appropriate.
Contribute innovative ideas and assist with the implementation of new processes.