Stop-Loss Claims Training Lead

Brown & Brown; United States; On-site; USD 80,000 - 100,000; Full time

Benefits offered by this job

Health Benefits

401k

Tuition Reimbursement

Paid Time Off

Job summary

Brown & Brown is seeking a Trainer Stop Loss Claims to join our growing team! The incumbent is responsible for providing training for newly hired Specific Stop Loss claims auditors and refresher training for all Specific Stop Loss claims auditors.

Develop a comprehensive curriculum, establish objective progress measures, and train staff to readiness for production. Serve as SME for the team and drive process improvements across the claims function.

Qualifications

• 3-5 years of Specific Stop Loss Claim experience.
• Prior Team Lead or Management experience in stop loss claims to include experience with quality assurance.
• Prior experience with industry repricing methodologies. (PPO, Wrap Networks, Reference Based Pricing, etc.)
• Demonstrated proficiency in Microsoft Office, including Microsoft Outlook.
• Demonstrated strong analytical/critical thinking skills; and detail‑oriented focus.
• Strong written and verbal communication skills.
• Ability to work independently with minimal supervision.

Responsibilities

• Develop a training curriculum with all necessary materials/documentation, covering all aspects of specific stop loss claims including, but not limited to logging claims, preparing working copies; system line-item data entry, completing claim checklists and examining all claim details; pending and/or releasing payments, pend follow up and correspondence handling.
• Establish an objective measuring tool for tracking trainee progress or lack thereof.
• Train all new specific stop loss claim auditors to determine whether they have successfully completed the training program and are ready to be placed in production with their team.
• Serve as a subject matter expert for and assigned claims team and provide technical guidance related to specific stop loss claims to the team.
• Review and Analyze Specific Stop Loss claims referred by auditors or as requested by clients and assist with over authorization reviews.
• Audit Specific Stop Loss claims during peak periods.
• Ensure continuous process improvement opportunities are reviewed and implemented, as appropriate.
• Contribute innovative ideas and assist with the implementation of new processes.

Skills

Specific Stop Loss Claims

Team Lead Experience

QA / Quality Assurance

Industry repricing methodologies

Microsoft Office

Analytical thinking

Written and verbal communication

Independent work

Tools

Microsoft Office

Job description

Brown & Brown is seeking a Trainer Stop Loss Claims to join our growing team! The incumbent is responsible for providing training for newly hired Specific Stop Loss claims auditors and refresher training for all Specific Stop Loss claims auditors.

Develop a comprehensive curriculum, establish objective progress measures, and train staff to readiness for production. Serve as SME for the team and drive process improvements across the claims function.