Senior Stop Loss Specialist

Imagine360 is seeking a Senior Stop Loss Specialist to join the team!  This position coordinates the tracking, monitoring, documenting and submission of stop loss claims. This position maintains a comprehensive understanding of the plan document(s) under their scope of responsibility.

Position Location: 100% remote

Responsibilities include but are not limited to:

• Stop Loss Claims Management

• Compiles and submits stop loss claims to the carrier for reimbursement.

• Enters appropriate stop loss claims into designated database.

• Identifies, researches, and resolves stop loss carrier questions.

• Facilitates advancement funding with Finance Department.

• Complies with reporting and documentations requirements.

• Manages large case notifications process.

• Customer Service

• Acts as a role model in demonstrating the core values in customer service delivery.

• Provides timely and thorough follow up with internal and external customers.

• Appropriately escalates difficult issues up the chain of command.

• Trains new employees as assigned.

• Quality Assurance

• Serves on committees, work groups, and/or process improvement teams, as assigned, to assist in improving customer satisfaction.

• Recognizes, documents, and alerts appropriate supervisor of trends

• Performs self-quality monitoring in order to develop and execute plans to meet established goals.

• Provides ongoing feedback to help optimize quality performance.

• Collaborates with others and cross-departmentally to improve or streamline procedures.

• Develops new or improves current internal processes to improve quality

Required Experience/Education:

• High School Diploma or GED.

• 1+ years' experience in clerical and customer service

• Knowledge of medical terminology

Skills and Abilities:

• Working knowledge of computers and software including but not limited to Microsoft Office products

• Proficient mathematical, 10-key and typing skills

• Demonstrated organizational skills, problem-solving, analytical skills and detail oriented

• Demonstrated ability to remain neutral and maintain confidentiality

• Strong written and oral communication skills

• Demonstrated ability to work independently, prioritize workloads multi-task and manage priorities in order to meet deadlines

What can Imagine360 offer you?

• Multiple Health plan options

• Company paid employee premiums for disability and life insurance

• Parental Leave Policy

• 20 days PTO to start / 10 Paid Holidays

• Tuition reimbursement

• 401k Company contribution

• Company paid Short & Long