Collect, review and prepare data to issue to market for quotes into the stop loss program(s).
Assist with the implementation process with teams, TPA's and stop loss carriers.
Assist in the review of all agreements and/or documents related to client's stop loss coverage including policy and ASO agreement.
Assist in ongoing case and experience data to help recommend implement appropriate case management and cost recovery programs.
Meet with teams in conjunction with Team or Company Leadership to review monthly a) large claims, b) abnormal utilization results, c) managed care and ongoing case management opportunities.
Assist with client/carrier issue resolution including but not limited to gray claims resolution.
Review all agreements and/or documents for accuracy.
Coordinate workflow with Senior Account Executive and/or Account Executive.
Participate in monthly LDBC meeting.
Other responsibilities as required.
Requirements:
As a minimum an Associate Degree in a business related field or equivalent experience in the insurance industry.
At least 2 years experience in the insurance industry, specifically in employee welfare benefits.
Strong customer service skills, with the ability to develop strong client relationships with multiple clients.
A firm working knowledge of welfare benefits with a basic understanding of risk and insurance concepts.
Ability to interact with vendors effectively.
Excellent computer skills including word processing and spreadsheet expertise.
Good working knowledge of differing financial arrangements and products available to clients (i.e. fully insured, minimum premium, ASO).
Must have excellent critical thinking and claims resolution expertise.
Current required licenses or ability to immediately obtain.
Excellent organizational and communication skills.
Must be available for travel and willing to accept responsibility for client/vendor entertainment.