Senior Stop Loss Representative (Finance)

Our organization is looking for dynamic individuals who love to learn, thrive on innovation, and are open to exploring new ways to achieve our goals.  If this describes you, we want to speak with you. You can help us achieve our vision to lead nationally in innovating equitable whole-person health.

The Senior Stop Loss Representative will perform activities related to managing inventory, filing submissions to stop loss carriers for reimbursement, distributing monthly stop loss reporting to appropriate contacts, auditing reports for accuracy before issuing, maintaining detailed tracking and storage of supporting documentation, attending a meeting with account management, brokers, and/or support team as needed to answer questions and/or resolve issues. This includes but is not limited to projects, updating claimant ID numbers/merging multiple records to track all stop loss claim dollars, processing external PBM files, and additional duties assigned to support the team as needed.

 

• Manage Inventory
• Maintain claimant files.
• Update group/broker/carrier contact information as needed.
• Distribute monthly stop loss reporting.
• Process external PBM files monthly
• Open tickets for issues and follow through to resolution.
• Follow up on all open items timely.
• Reconcile accounts and communicate discrepancies immediately.
• Manage working relationships with internal and external business partners.
• Attend meetings to resolve issues as needed.
• Perform other duties as necessary or appropriate for the position.

 

• Bachelor's degree in business operations or equivalent work experience
• More than two years working in an operations environment.
• Knowledge of claims processing preferred.
• Previous experience in Reinsurance or Stop Loss/Healthcare experience preferred.
• Experience working in a production driven environment.
• Self-starter, highly motivated problem solver with the ability to work independently.
• Ability to multi-task and handle deadline driven assignments.
• Ability to perform appropriate research, make responsible decisions and demonstrate customer-oriented professionalism.
• Strong organization skills and attention to detail capabilities are required.
• Strong communication and competency skills are necessary.
• Ability to follow documented procedures and instructions.
• Cross-functional team collaboration abilities are required.
• Punctual, positive, professional, accountable, innovative, team-oriented, and emotionally intelligent candidates are preferred.

Hybrid

Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania.

Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.