Stop Loss Coordinator
Job Description
Consociate Health, a leading Third-Party Administrator, offers an opportunity to grow and develop your career in an environment that provides a fulfilling workplace for employees, and creates continuous learning and embraces the ideas and diversity of others.
As part of our Mission to make Healthcare more accessible and affordable for our clients through innovation solutions and expert consultation, we value the inherent qualities that are foremost in our Mission, Vision, Values- Compassion, Humility and Impact, which allow us all to create authentic relationships with our team and our clients.
The position will report to the Stop Loss Manager of Consociate Health. The Stop Loss Coordinator will be responsible for all aspects of the stop loss process as it relates to client stop loss claims and reimbursement.
Principal Duties and Responsibilities:
- Work closely with our stop loss carriers externally, as well as the Claim’s Department internally, to ensure all claims eligible for stop loss reimbursement are received, reported and processed timely. Provides updates to internal teams, vendors and clients as needed.
- Complete and file appropriate documentation to stop loss carriers for specific and aggregate claims. This includes but is not limited to 50% notifications, claim reimbursements, additional information as requested by the carrier, etc.
- File stop loss reimbursement claims for assigned clients according to the requirements of each stop loss contract.
- Monitor reimbursements from stop loss carrier. Work with general underwriters, carriers and clients to resolve any issues regarding stop loss reimbursement.
- Updates current spreadsheet of filed and outstanding reinsurance claims as well as denied claims.
- Perform other duties as assigned.
