Supervisor, Stop Loss

POSITION SUMMARY

The Supervisor, Stop Loss is responsible for assisting the Manager, Stop Loss with overseeing the department.  Duties include auditing and tracking stop loss claim filings, reimbursements, and cash advance claims to ensure the department is running in an efficient and thorough manner. The Supervisor, Stop Loss also works closely with Stop Loss Data Specialist and Reimbursement Specialist on administrative, organizational, and auditing functions.

ESSENTIAL FUNCTIONS

• Perform weekly audits of specific claims to ensure all claims were filed correctly and all reimbursements have been received.
• Update and manage the stop loss tracking and specific logs to monitor the current status of members over the specific deductible.
• Review and accurately record stop loss reimbursements.
• Gather and prepare the data required to file Rx stop loss claims.
• Responsible for the filing of aggregate claims and securing reimbursements.
• Assist with making claim adjustments.
• Organize the enrollment of new clients into the ACH reimbursement program.
• Lead, coach, motivate and develop. Responsible for one-on-one meetings, performance appraisals, growth opportunities and attracting new talent.
• Clearly communicate expectations, provide employees with the training, resources, and information needed to succeed.
• Actively engage, coach, counsel and provide timely, and constructive performance feedback.
• Performs other related duties as assigned.

EDUCATION

• Bachelor’s degree or equivalent work experience required.

EXPERIENCE AND SKILLS

• At least 5 years group health insurance/benefits experience required. 
• At least 2 years supervisory experience required.
• Must be highly proficient in the use of Microsoft Word, Excel, and Outlook
• Must have the ability to easily learn new computer applications.

POSITION COMPETENCIES

• Accountability
• Communication
• Action Oriented
• Timely Decision Making
• Building Relationships/Shaping Culture
• Customer Focus

PHYSICAL DEMANDS

• This is a standard desk role – long periods of sitting and working on a computer are required.

WORK ENVIRONMENT

• Remote

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive