Centivo

Stop Loss Analyst

Centivo

full-time

Posted on:

Location Type: Remote

Location: United States

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Salary

💰 $65,000 - $70,000 per year

About the role

  • Maintain a process for identifying potential specific claimants within each client’s utilization data
  • Manage specific and aggregate claim submission processes, acting as liaison between Centivo and its stop loss carrier partners
  • Ensure new carriers have Non-Disclosure Agreements in place before sharing any client data
  • Provide stop loss carrier with necessary information required for claim reimbursement consideration and appeal submissions
  • Request changes to stop-loss policy and/or client SPD as needed to ensure seamless coverage
  • Participate in internal workgroups and task force(s) as needed to successfully implement stop loss administration in claims system
  • Analyze stop-loss policies against the quote, application, and plan document for accuracy and agreement
  • Create and deliver monthly reports to carriers, including Aggregate Accommodations and Year-End Aggregate Filings
  • Schedule and automate recurring reporting tasks to meet internal and carrier-specific goals
  • Generate timely and accurate financial data for monthly report submissions
  • Proactively reviews weekly reports to identify potential high-cost claimants
  • Participate actively in team and department meetings on stop loss administration process and client/product implementation planning
  • Ensure stop loss industry knowledge is current, bringing forward ideas and recommendations to ensure Centivo has competitive position in the marketplace
  • Convey renewal information for stop-loss rates internally within Centivo
  • Utilize developed understanding of all aspects of operational functions to efficiently perform to the established service standards as related to renewals and client service
  • Elevate client issues and concerns to appropriate Manager, Client Services and/or Account Management
  • Performs other miscellaneous projects, assignments, and duties as assigned by management

Requirements

  • 4 years of experience in stop loss, claims operations, financial analytics, customer service, or client services required
  • Associates degree required; Bachelor’s degree preferred
  • Stop Loss policy management and marketing experience required, specifically with self-funded insurance, level-funded based client knowledge
  • Knowledge of the claims/submission process
  • Advanced knowledge of Microsoft Office products (Excel, Power Point, Word)
  • Strong customer service, organizational and time management skills
  • Demonstrated ability to meet performance goals, including accuracy and productivity
  • Excellent written, verbal, and interpersonal communication skills
  • Ability to access, operate, and maintain various software applications
  • Ability to work independently with minimal supervision
  • Strong interpersonal skills, establishing rapport and working well with others
Benefits
  • Offers Equity
  • Offers Bonus
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
stop loss policy managementclaims operationsfinancial analyticscustomer serviceclient servicesclaims submission processreport generationdata analysispolicy accuracy verificationrenewal information management
Soft Skills
organizational skillstime management skillscustomer service skillsinterpersonal communicationwritten communicationverbal communicationability to work independentlyproblem-solving skillsteam collaborationperformance goal achievement
Certifications
Associates degreeBachelor’s degree (preferred)