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.
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.