Track, calculate and pursue overpayments identified within Stop Loss department
Researching of files, have full understanding of claims, type of overpayment, overpayment resolution options and total knowledge of systems used by claims department
Follow up of overpayment requests which may include discussions 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
expert level understanding of the Stop Loss claims process or Medical Claims
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
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