Stop Loss Claims Manager

About SBR Ancillary, a division of Strategic Benefit Resources: SBR is a division of Specialty Program Group, a wholly owned subsidiary of HUB International. Our mission is to solve problems, create a better experience, and produce results for our broker, carrier, and benefits technology partners. We pride ourselves on encouraging creativity with each problem, embracing collaboration at every opportunity, and empowering commitment to expected results. Our expertise lies in dental, vision, life, disability, supplemental health, and leave management. Our organization is comprised of four integrated teams: marketing, client service, leave management solutions, and business operations. As an extension of a brokerage’s consulting and service teams, we support marketing, sold case implementation, account support, renewal management, analytics & insights, carrier eligibility, benefits technology builds, and leave administration & state disability compliance.

Key Responsibilities:

• Exhibits an attention to detail and a strong work ethic.

• Exhibits the ability to access and utilize research tools for accurate claims entry.

• Ability to read and understand reinsurance contracts and Summary Plan Descriptions.

• Possesses good organizational skills and can manage time and resources effectively and efficiently.

• Possesses a thorough knowledge of coding structures (CPT, HCPCS, UB/Revenue codes, ICD 9/10 etc.)

• Ability to perform arithmetic calculations.

• Good understanding of benefits and benefit calculations.

• Performs duties in a HIPAA compliant manner.

• Participates as a team member to ensure the smooth operation of the entire department.

• Maintains guidelines and notes with detail to enable accurate stop loss filings for reimbursement to the group.

• Maintains Turnaround Time (TAT) guidelines and accuracy goals with filing of Aggregate and Specific stop loss claims.

• Files stop loss claims - initial, subsequent and/or final filings, making sure all necessary documentation is included and submitted in a timely manner.

• Reviews accuracy of claims included with reimbursement requests to prevent additional delay once the reinsurance claim has been received by the carrier.

• Maintenance of stop loss claims information in Salesforce.

• Troubleshoot claim issues as needed.

• Develops and maintains relationships with the various brokers, carriers and contacts at the clients.

• Complies with departmental policies and procedures.

• Assists in training/mentoring of other employees at the Supervisor or Manager’s request to ensure consistency within the stop loss department.

• Performs special projects at the request of Management.

• Demonstrates the ability to complete root cause analysis and develop process improvement plans to present to Management.

• Advanced proficiency and experience using Microsoft Office software and familiarity with Salesforce is a plus.

Salary Transparency: The expected salary range for this position is $50,000-$55,000 and will be impacted by factors such as the successful candidate’s skills, experience and working location, as well as the specific position’s business line, scope and level. HUB International is proud to offer comprehensive benefit and total compensation packages which could include health/dental/vision/life/disability insurance, FSA, HSA, and 401(k) accounts, paid-time off benefits, and eligible bonuses, equity, and commissions for some positions.

Department Claims Management

Required Experience: 2-5 years of relevant experience

Required Travel: No Travel Required

Required Education: Bachelor's degree (4-year degree)

HUB International Limited is an equal opportunity employer that does not discriminate on the basis of race/ethnicity, national origin, religion, age, color, sex, sexual orientation, gender identity, disability or veteran's status, or any other characteristic protected by local, state or federal laws, rules or regulations.

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