Senior Claim Benefit Specialist - Stop Loss (Hybrid)

Full-time

Hybrid - Amherst, NY

Health and Personal Care Retailers

About the position

Are you looking for an exciting opportunity to join a dynamic team that is an important, strategic part of a Fortune 5 company in one of the fastest growing fields in the healthcare industry? This challenging role provides exposure to virtually all aspects of healthcare claims administration, from reinsurance/stop loss, data analytics, provider and broker relations, underwriting, eligibility, finance, client management and much more. Develop and hone your skills as a critical thinker, problem solver, and highly effective communicator with a meticulous eye for detail and superior organization - foundational skills that will serve you throughout your entire career. We will provide extensive training and a promising career path for the right candidate willing to learn and grow into a promising and stable line of work. You will act as an important liaison and subject matter expert between our internal and external stakeholders and the stop loss administrators. Managing stop loss claim filings, you will reconcile and resolve discrepancies between the amount requested and the amount reimbursed by the stop loss carrier.

Responsibilities

• Act as a liaison and subject matter expert between internal and external stakeholders and stop loss administrators.
• Manage stop loss claim filings.
• Reconcile and resolve discrepancies between the amount requested and the amount reimbursed by the stop loss carrier.

Requirements

• Minimum of 1 year of experience in healthcare claims processing.
• Minimum of 2 years of experience with the suite of Microsoft applications (particularly Excel).
• Ability to work independently across a matrix team in a fast-paced environment.
• Strong interpersonal and communication skills (verbal and written) and pride in your work.

Nice-to-haves

• Experience in stop loss administration.
• Exposure to a mainframe IBM AIX or AS/400 environments (i.e. 'green screen', command driven platforms).

Benefits

• Full range of medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Employee Stock Purchase Plan.
• Fully-paid term life insurance plan.
• Short-term and long-term disability benefits.
• Numerous well-being programs.
• Education assistance.
• Free development courses.
• CVS store discount.
• Discount programs with participating partners.
• Paid Time Off (PTO) or vacation pay.
• Paid holidays throughout the calendar year.