Trainer Stop Loss Claims

Visa Hunt; United States; On-site; USD 80,000 - 100,000; Full time

Benefits offered by this job

Health Benefits

401k

Student Loan Assistance

Tuition Reimbursement

Mental Health Services

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.

You will develop a training curriculum, establish measurement tools, and train auditors to production readiness, while serving as a subject matter expert and driving process improvements.

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 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.
• Establish an objective measuring tool for trainee progress.
• Train all new specific stop loss claim auditors to determine readiness for production with their team.
• Serve as a subject matter expert for and provide guidance to the assigned claims team.
• Review and analyze specific stop loss claims and assist with over-authorization reviews.
• Audit specific stop loss claims during peak periods.
• Ensure continuous process improvement opportunities are reviewed and implemented.
• Contribute innovative ideas and assist with implementing new processes.

Skills

Specific Stop Loss Claims

Team Lead / Management experience

Industry repricing methodologies

Microsoft Office

Communication skills

Independent work

Tools

Microsoft Outlook

Job description

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers.

Brown & Brownis seeking a Trainer Stop Loss Claimsto join our growing team!

The incumbentis responsible forproviding training for newly hired Specific Stop Loss claims auditors and refresher training for all Specific Stop Loss claims auditors.

How You Will Contribute:

• 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; systemline-itemdata 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 theirteam.

• Serve as a subject matter expert for and assigned claims team andprovide 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 andassistwith 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 andassistwith the implementation of new processes.

Skills & Experience to be Successful:

• 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 BasedPricing,etc.

• Demonstratedproficiencyin Microsoft Office,includingMicrosoft Outlook.

• Demonstrated strong analytical/critical thinkingskills;and detail‐oriented focus.

• Strong written and verbal communication skills.

• Ability to work independently with minimal supervision.

Preferred Qualifications:

• Prior experience auditing aggregate stop loss claims.

• History of successful Process Improvement initiatives.

• Prior experience leading a team or managing processes.

Pay Range

$80,000 - $100,000 Annual

The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for the role.

Teammate Benefits & Total Well-Being

We go beyond standard benefits, focusing on the total well-being of our teammates, including:

• Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance
• Financial Benefits: ESPP; 401k; Student Loan Assistance; Tuition Reimbursement
• Mental Health & Wellness: Free Mental Health & Enhanced Advocacy Services
• Beyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts and more.

Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations.

Recruiting Vendor Disclosure Statement

Brown & Brown does not accept unsolicited resumes from external recruiters, recruitment vendors or employment agencies ("Recruiting Vendors"). Recruiting Vendors must have a valid written agreement and received prior written authorization from an authorized Brown & Brown representative before submitting candidates for any publicly posted role. Any unsolicited resumes submitted to Brown & Brown or its employees become the property of Brown & Brown, and no fees will be paid for such submissions. Additional information regarding this policy can be found on our careers page.

The Power To Be Yourself

As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, “The Power to Be Yourself”.

Originally posted on Himalayas