Senior Stop Loss Representative

Sr. Stop Loss Representative

The Sr. Stop Loss Representative is responsible for the administration and reporting for branded (Blue) and unbranded (AmeriHealth) customers for Independence, Independence Administrators, and AmeriHealth Administrators.

This position is responsible for reviewing, evaluating and processing various Excess Risk and Reinsurance Claims. It is responsible for promoting positive client relationships, education and analysis of client claims losses as well as analysis and resolution of current Stop Loss reimbursement issues. Work collaboratively with our internal and external customers including Sales, Client Retention, Audit, Claims, Enrollment, Contracts, Legal, OPL, Patient Care Management, Groups, Brokers, and Stop Loss Carriers (both managing general underwriters and reinsurers).

• 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, 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.

Qualifications

• Two years related experience in claims processing or stop loss and or reinsurance required
• Ability to prioritize varied tasks to ensure the timely and accurate completion of each task
• Self-starter, highly motivated, problem solver with the ability to work independently in a fast pace environment
• Demonstrate exceptional comprehension and communication skill
• The ability to perform appropriate research, make responsible decisions, and demonstrate customer-focused professionalism required
• Excellent interpersonal skills with the abilities to collaborate through resolution.
• Strong organizational skills and attention to detail capabilities are required.
• Obtain and maintain the necessary skills to access information from various systems in order to efficiently handle inquiries and submit claim filings
• Strong oral and written communication skills required

IBX is an Equal Opportunity 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.