Senior Stop Loss Representative
The SR. Stop Loss Representative is responsible for the administration and reporting for branded (Blue) and unbranded (AmeriHealth) customers for Independence, Independence Administrators, and AmeriHealth Administrators.
This position is responsible for reviewing, evaluating and processing various Excess Risk and Reinsurance Claims. It is responsible for promoting positive client relationships, education and analysis of client claims losses as well as analysis and resolution of current Stop Loss reimbursement issues. Work collaboratively with our internal and external customers including Sales, Client Retention, Audit, Claims, Enrollment, Contracts, Legal, OPL, Patient Care Management, Groups, Brokers, and Stop Loss Carriers (both managing general underwriters and reinsurers).
- Manage Inventory
- Maintain claimant files.
- Update group/broker/carrier contact information as needed.
- Distribute monthly stop loss reporting.
- Process external pbm files monthly
- Open tickets for issues and follow through to resolution.
- Follow up on all open items timely.
- Reconcile accounts, communicate discrepancies immediately.
- Manage working relationships with internal and external business partners.
- Attend meetings to resolve issues as needed.
- Perform other duties as necessary or appropriate for the position.
Qualifications
Two years related experience in claims processing or stop loss and or reinsurance required
Ability to prioritize varied tasks to ensure the timely and accurate completion of each task
Self-starter, highly motivated, problem solver with the ability to work independently in a fast pace environment
Demonstrate exceptional comprehension and communication skill
The ability to perform appropriate research, make responsible decisions, and demonstrate customer-focused professionalism required
Excellent interpersonal skills with the abilities to collaborate through resolution.
Strong organizational skills and attention to detail capabilities are required.
Obtain and maintain the necessary skills to access information from various systems in order to efficiently handle inquiries and submit claim filings
Strong oral and written communication skills required
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
Inclusion and Belonging
At IBX, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
About Our Company
Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.
At Independence, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com. We’re revolutionizing health care, and our focus is on you!
Equal Employment Opportunity
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an Independence Blue Cross employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of Independence Blue Cross and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by Independence Blue Cross or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.