Large Claims Coordinator

Highlight Health; Philadelphia (Philadelphia County); Hybrid; USD 63,000 - 77,000; Full time

Benefits offered by this job

Healthcare benefits

401(k) contributions

Bonuses

Paid time off

Commuting benefits

Hybrid work after probation

Job summary

Highlight Health is a profitable, fast-growing company protecting consumer rights and controlling healthcare costs for self-funded plans. The Large Claims Coordinator role focuses on coordinating across Sales, Account Management, Legal, and Claims Analysis, ensuring timely resolution of large claims and clear external communication.

Ideal candidates excel in cross-functional collaboration, organization, and problem solving, with strong interpersonal skills and medical knowledge.

Qualifications

• Ability to organize and prioritize a variety of tasks in a fast-moving environment.
• Strong interpersonal and problem-solving skills.
• Strong communication skills.
• Ability to take initiative and build out necessary resources and workflows.
• Medical/clinical knowledge.
• College degree preferred.

Responsibilities

• Serve as the primary liaison across Sales, Account Management, Legal, and Claims Analysis teams, as well as the main point of contact for external partners.
• Organize, prioritize, and initiate items that need to be completed amongst teams, and prioritize them based on internal and external factors.
• Manage the Large Claims inventory by running reports, monitoring daily activity and identifying risks, delays or process improvement opportunities.
• Lead multiple weekly meetings between key stakeholders to ensure large claims are being efficiently worked.
• Produce and disseminate materials summarizing claims analysis on large claims.
• Communicate findings to external parties in both written and presented formats.
• Assist executives in any other duties as required as it relates to the working of large claims.
• Draft and distribute materials for both internal and external usage that explains HLH processes for Large and Special claims

Skills

Interpersonal skills

Problem-solving

Communication

Initiative

Organization

Medical knowledge

Education

College degree

Job description

Job Description

Job Description

Overview

Highlight Health is a profitable, fast-growing company that protects consumer rights and controls healthcare costs for self-funded plans.

Highlight Health is redefining cost containment for self-funded health plans, participants, and stop-loss carriers. We save money for plans and participants, while assisting plan sponsors in fulfilling their fiduciary duties. We are an independent, nationally recognized healthcare cost containment company that uses innovative technology and sound industry knowledge and experience, to drive success. Our combination of expertise and technology sets the industry standard for independent healthcare cost containment and guidance services.

We are seeking a motivated, hard-working individual to help streamline and optimize the most crucial aspect of our business – large claims analysis and resolutions. The Large Claims Coordinator role will require strong interpersonal and organizational skills as well as the ability to prioritize and satisfy deadlines. The best candidates for this position should excel in inspiring confidence between a variety of internal teams as well as being able to communicate with external parties.

Essential Duties and Responsibilities

• Serve as the primary liaison across Sales, Account Management, Legal, and Claims Analysis teams, as well as the main point of contact for external partners

• Organize, prioritize, and initiate items that need to be completed amongst teams, and prioritize them based on internal and external factors

• Manage the Large Claims inventory by running reports, monitoring daily activity and identifying risks, delays or process improvement opportunities

• Lead multiple weekly meetings between key stakeholders to ensure large claims are being efficiently worked

• Produce and disseminate materials summarizing claims analysis on large claims

• Communicate findings to external parties in both written and presented formats

• Assist executives in any other duties as required as it relates to the working of large claims

• Draft and distribute materials for both internal and external usage that explains HLH processes for Large and Special claims

Experience and Qualifications

• Ability to organize and prioritize a variety of tasks in a fast-moving environment
• Strong interpersonal and problem-solving skills
• Strong communication skills
• Ability to take initiative and build out necessary resources and workflows
• Medical/clinical knowledge
• College degree preferred

Compensation and Benefits

• Compensation:

• Starting Salary: $70,000

• Benefits:

• Highlight Health offers an attractive benefits package, with healthcare cost reimbursement, paid time off, commuting benefits, short term disability, an employer 401(k) contribution, and bonuses.

• After 90 days of employment, you may work from home 2 days/week.