- Highmark Health (Olympia, WA)
- … in accordance with department standards. **ESSENTIAL RESPONSIBILITIES** + Processes daily incoming Stop Loss claims including initial entry claims ... experience with medical terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise… more
- CVS Health (Amherst, NY)
- …This challenging role provides exposure to virtually all aspects of healthcare claims administration, from reinsurance/ stop loss , data analytics, provider ... expert between our internal and external stakeholders and the stop loss administrators. Managing stop ...Qualifications** *Minimum of 1 year of experience in healthcare claims processing *Minimum of 2 years of experience with… more
- CRC Insurance Services, Inc. (Phoenix, AZ)
- …the following job description:** This role is responsible for managing key stop loss client accounts, nurturing strong and trusted relationships, overseeing ... team to develop renewal strategies and ensure client retention. Serve as a stop loss subject matter expert for Account Management team and the organization.… more
- Elevance Health (Latham, NY)
- …Will Make an Impact** Primary duties may include, but are not limited to: + Calculates stop loss rates for complex group cases based on thorough analysis of the ... Group Underwriter Senior **Location:** This role requires associates to be...LOMA, HIAA or other insurance related courses preferred. + Stop Loss underwriting experience preferred + Demonstrated… more
- CRC Insurance Services, Inc. (Phoenix, AZ)
- …and maintain strong client relationships with employee benefit brokers and consultants, stop loss carriers, and various clinical point solutions providers. ... stop - loss . In-depth knowledge of Self-funded employee benefit plans, stop loss insurance, and risk management principles. CERTIFICATIONS, LICENSES,… more
- Providence (Mission Hills, CA)
- … Claims Specialist is responsible for the processing of complex institutional claims ( stop loss , contracted, non-contracted, per diem, case rate etc.) ... and adjudication and claims research when necessary. Senior Claims Specialist must have knowledge of compliance issues as they relate to claims … more
- HUB International (Brentwood, TN)
- …lien holder or other parties as needed. This includes releases, dismissal entries, proofs of loss , etc. + Ensure Claims payments are issued in a timely and ... under which our subsidiaries reside: + Avant Underwriters (AU + Avant Specialty Claims (ASC) + Avant Brokerage (AB) + Avant Supermarket Group (ASG) + SafeHerb… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …plan performance against benchmarks and internal targets, identifying emerging risks related to claims volatility, stop - loss and value-based care programs. + ... contribute to the diversity and excellence of our academic community. **Description** The Senior Director of Finance will serve as the financial leader of the Emory… more
- Axis (Red Bank, NJ)
- …to engage in reinsurance pricing efforts. Products supported by the department include Stop - Loss , Short Term Medical/Limited Medical, Excess of Loss , Pet ... is available upon request for candidates taking part in the selection process. ** Senior A&H Pricing Actuary** **How does this role contribute to our collective… more
- Geisinger (Danville, PA)
- … Senior Underwriter with strong expertise in Administrative Services Only (ASO), Stop Loss , and pharmacy risk evaluation to join our dynamic team. ... and pricing strategies to achieve target financial results. + Analyze claims experience, demographics, benefit plans, group attributes and competitor data. Applies… more
- Southland Industries (Garden Grove, CA)
- …+ Collaborate with Finance and brokers to evaluate self-insured program performance, stop - loss coverage, and claims experience. + Ensure compliance ... **POSITION SUMMARY** The Senior Benefits Specialist supports the design, administration, and continuous improvement of employee benefits programs, with an emphasis… more
- CareFirst (Baltimore, MD)
- …process includes the following requirements: completing group risk renewals, completing ASO/ Stop Loss renewals, quoting alternate benefits designs, funding ... basic (Demographically Rated) quotes. Completing Complex (Experience Rated) quotes. Completing Stop Loss and ASO quotes. Applying underwriting judgment when… more
- Washington Suburban Sanitary Commission (WSSC) (Laurel, MD)
- …such as partial or full self-funding and recommend retention levels and stop loss limits, etc. * Monitors claims activity and reviews claims reserves ... Position Summary Information General Summary TheSr. Strategic Financial Advisorprovides senior -level internal financial consulting services in support of key… more
- AdventHealth (Altamonte Springs, FL)
- …actuarial functions, eg, claims completion, seasonality analysis, risk scoring, and stop loss analysis is also essential. Ideal experience is in the ... solving and computational skills is essential. Additionally, working knowledge and understanding of major medical claims , insurance contracts, and the traditional… more