Primary Responsibilities and Duties:
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Analyze Aggregate Stop Loss claims
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Validate which expenses are eligible under the aggregate stop loss contract
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Perform enrollment evaluation and calculations to ensure the correct attachment is applied
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Produce deliverables related to audit findings, including Audit Report for client, Exhibits and Non Exhibits, within the Company accepted timeframes
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Contribute innovative ideas and assist with the implementation of new processes
Requirements and Qualifications:
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Must have Excel Proficiency to include knowledge of Basic or Advanced Formulae and PIVOT Tables
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Minimum 2 years of experience with self-funding in combination with first dollar medical claims plus specific and/or aggregate claims; or first dollar medical claims plus HMO reinsurance and/or provider excess claims
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Prior experience auditing managed care or specific/aggregate stop loss claims
Corporate Benefit Audits, Inc. (CBA), a division of Risk Strategies Company, headquartered in North Andover, MA since 1992, has provided audit services to Carriers, MGU’s, Reinsurers and Employer clients managing healthcare risk and associated Stop Loss Reinsurance concerns. The incumbent is responsible for providing Specific Stop Loss claims auditing services for MGU and/or Carrier clients.
At Risk Strategies Company, base pay is one part of our total compensation package, which also includes a comprehensive suite of benefits, including medical, dental, vision, disability, and life insurance, retirement savings, and paid time off and paid holidays for eligible employees. The total compensation for a position may also include other elements dependent on the position offered. The expected base pay range for this position is between $65,750 - $90,000. The actual base pay offered may vary depending on multiple individualized factors, including geographical location, education, job-related knowledge, skills, and experience.
Risk Strategies is the 9th largest privately held US brokerage firm offering comprehensive risk management advice, insurance and reinsurance placement for property & casualty, employee benefits, private client services, as well as consulting services and financial & wealth solutions. With more than 30 specialty practices, Risk Strategies serves commercial companies, nonprofits, public entities, and individuals, and has access to all major insurance markets. Risk Strategies has over 100 offices and nearly 5,000 employees across the US and Canada.
Our industry recognition includes being named a Best Places to Work in Insurance for the past five years (2018-2022) and on the Inc. 5000 list as one of America’s Fastest Growing Private Companies. We are committed to being good stewards for our company, culture, and communities by having a strong focus on Environmental, Social, and Governance issues.
Risk Strategies is an equal opportunity workplace and is committed to ensuring equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, Veteran status, or other legally protected characteristics. Learn more about working at Risk Strategies by visiting our careers page:
www.risk-strategies.com/careers
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