Supervisor, Stop Loss

Posted 5 Days Ago
Be an Early Applicant
Hiring Remotely in 60606, Chicago, IL, USA
In-Office or Remote
60K-65K Annually
Senior level
Healthtech
The Role
Supervise stop loss operations including auditing claim filings, tracking reimbursements and deductibles, filing aggregate and Rx stop loss claims, organizing ACH reimbursements, making claim adjustments, and coaching a small team to ensure accurate, timely processing.
Summary Generated by Built In

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.
  • Other 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
  • Coaching and Feedback
  • Collaboration
  • Customer Focus
  • Decision Making
  • Execution Management
  • People Leadership

 

PHYSICAL DEMANDS

  • This is a standard desk role requiring extended sitting and computer work.

 

WORK ENVIRONMENT

  • Remote

Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.

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 list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Compensation is not limited to base salary.  Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.

Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time.  All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process.  It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.

Skills Required

  • Bachelor's degree or equivalent work experience
  • At least 5 years group health insurance/benefits experience
  • At least 2 years supervisory experience
  • Proficiency with Microsoft Word, Excel, and Outlook
  • Ability to quickly learn new computer applications
  • Reliable cable broadband or fiber internet (minimum 100Mbps download/25Mbps upload) for remote work
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The Company
HQ: Chicago, IL
381 Employees
Year Founded: 1980

What We Do

Allied is a national healthcare solutions company that works with organizations who choose to take control of their healthcare. We customize employer self-insurance benefits to align with individual choice and organizational need while integrating medical management innovations and cost-control strategies. With healthcare designed for people, employers never have to choose between price and the best-fit insurance products to protect employees and their families. Allied’s philosophy is to create a culture of health for our member organizations and their employees beyond simple, medical health. We integrate administrative services, care solutions and analytics to achieve better clinical, behavioral and social patient outcomes. Allied’s programs and benefit services are designed and structured to infuse value on every front – for employers and HR departments, for plan members and their families, for healthcare providers, and for us. We’re in this together, committed to your future.

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