Track, calculate and pursue overpayments identified within Stop Loss department
Research files and understand claims, type of overpayment, overpayment resolution options
Follow up on overpayment requests with Administrator, Claim Analyst, Broker, both internal and external customers
Provide monthly current recovery reports (analysis, trending, actions, status)
Receive escheatment report, investigate customer data and provide data to banking for potential stop pay/re-issue of checks
Requirements
5+ years understanding of first dollar stop loss claims or medical claims
Requires expert level understanding of the Stop Loss claims process or Medical Claims with respect to how overpayments are determined
Prior experience in medical or Stop Loss claim adjudication
Proficient in Excel with advanced skills, including complex formula construction, pivot table manipulation, Vlookup, queries creation
Adept knowledge in navigating and utilizing SharePoint features at an intermediate level, including document management, tracker creation, and basic site administration
Strong understanding of business and relationship building with external customers
Highly skilled verbal and written communication skills.
Benefits
Generous vacation and sick time
Market-leading paid family, parental and adoption leave
Medical coverage
Company paid life and AD&D insurance
Disability programs
Partially paid sabbatical program
401(k) employer match
Stock purchase options
Employer-funded retirement account
Flexible, inclusive and collaborative work environment
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