Stop Loss Coordinator

Job Description

Job Description

Description:

Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Stop Loss Coordinator, you’ll play an important role in helping us offer customized, self-funded insurance options to our clients and members.

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.

Key Responsibilities

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

What You'll Need to Succeed

• 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.

• Education & Experience: Associate’s Degree or 2+ years of relevant work experience.
• Proficiency in MS Office: Solid experience with Microsoft Word, Excel, and Outlook.
• Industry Experience: 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.

Benefits

• Fantastic medical, dental, and vision insurance*
• Twice annual employer HSA contributions, covering 50% of the HDHP plan’s annual deductible!
• Company-provided Basic Life and AD&D
• Company-paid Short-Term and Long-Term Disability**
• Flexible Spending Accounts*
• 401(k) Retirement Plan with up to a 6% employer match** (100% fully vested after 3 years)
• 10+ paid holidays
• Generous paid vacation and sick time
• Annual Volunteer Paid Day
• Annual Tuition Reimbursement
• Annual Health and Wellness Reimbursement
• Lots of fun company events
• *60-day waiting period **90-day waiting period

Who We Are

As a trusted Third-Party Administrator (TPA) specializing in self-funded benefit plans, Cobalt Benefits Group (CBG) is committed to helping employers find high-quality coverage at a cost they can afford. We administer self-funded insurance benefits through our three companies: EBPA, Blue Benefit Administrators of Massachusetts, and CBA Blue.With over 30 years of experience and a dedicated team of more than 200 employees, we work collaboratively to build customized self-funded health plans, manage claim payments and disputes, and administer other specialized programs such as FSAs, HSAs, COBRA, and retiree billing. Join us as we match employers across our region with the right solutions for their employee benefit needs. To learn more about working at CBG, visit

Cobalt Benefits Group is an Equal Employment Opportunity Employer

Cobalt Benefits Group participates in E-Verify to confirm the employment eligibility of all new hires.