Department: Stop Loss
Location: Columbus, Ohio
Immediate Supervisor: Brandy Saylor
Posted: March 02 2017
Essential Functions of Job:• Responsible for assisting with overall department functions and workflow at all levels o Collection, analysis and creation of reporting used to determine medical claims cost and utilization o Claims data and financial reporting o Generating Stop Loss Aggregate Reports o Claim Research and Review o Identifying potential high dollar risks o Review of UR/CM Reporting o Comply with all carrier reporting requirements • Process stop loss claim filings, 50% notices and variety of claim and eligibility audits. • Renewal medical review and risk analysis • High level contact with stop loss carriers, case management vendors and internal executives • Other duties as assigned • Ability to report to the office
Qualifications:• Associate or Bachelor’s degree preferred, experience considered in lieu of degree • Effective organizational and prioritization skills • Excellent oral and written communication skills • Basic knowledge of Microsoft Office software applications (Word, Excel, Outlook, Access) • Ability to work in a fast paced multi-tasking environment • Strong interpersonal skills with ability to function as a positive team member or independently • Excellent analytical and investigative skills • Must be detail oriented • General accounting knowledge considered a plus • Stop Loss background and/or claims experience preferred • Previous financial analysis experience desired • Knowledge of industry standards, contracts and/or underwriting background helpful preferred
The Company considers applicants without regard to race, color, national origin, sex, religion, mental or physical disability, marital status, age 40 years and over, sexual orientation or gender identity, veteran's status, or other characteristic protected by applicable law.
Applications for this vacancy will be received for 3 working days after the Posted date from Employees of HealthSCOPE Benefits with more than one year of service.
Applications for this vacancy will be received for 10 working days after the Posted date from External Applicants.