Crum & Forster

Claims Examiner, Medical Stop Loss

Crum & Forster

full-time

Posted on:

Location Type: Remote

Location: Arizona • United States

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Salary

💰 $48,300 - $90,800 per year

About the role

  • Within documented authority levels, review all claim submissions for accuracy, completeness, and compliance with various Plan Documents, SPDs, and Policies
  • Clearly and professionally communicate external requests for information and maintain timely follow-up
  • Clearly and professionally communicate claim payment and denial decisions
  • Confirm appropriate disclosure when applicable
  • Calculate and maintain reserves as needed
  • Assist with aggregate accommodation activities and aggregate claim submissions
  • Maintain appropriate reporting and communication with team and management regarding your assigned areas of responsibility
  • Assist with refining internal claim procedures and recommending improvements to management
  • Other duties as assigned

Requirements

  • 3+ years medical stop loss claim experience required
  • Bachelor’s degree or equivalent experience required
  • Strong working knowledge of both Microsoft Office suite with an aptitude to learn new programs (ESL Office experience preferred)
  • Ability to establish a good rapport with all stakeholders
  • Commitment to delivering outstanding customer service and satisfaction
  • Commitment to exploring and assisting in implementing new processes to increase effectiveness and achieve organizational goals
  • Exceptional attention to detail and accuracy
  • Capability to manage multiple priorities in a fast-paced environment
  • Excellent written and verbal communication skills
Benefits
  • Competitive compensation package
  • Generous 401K employer match
  • Employee Stock Purchase plan with employer matching
  • Generous Paid Time Off
  • Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family’s wellness, including your physical, mental and financial wellbeing
  • A core C&F tenet is owning your career development, so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training to keep you progressing on your chosen path
  • A dynamic, ambitious, fun and exciting work environment
  • We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community
Applicant Tracking System Keywords

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

Hard Skills & Tools
medical stop loss claim experienceclaim submissionscalculating reservesinternal claim proceduresaggregate accommodation activities
Soft Skills
communication skillscustomer serviceattention to detailability to manage multiple prioritiesrapport building
Certifications
Bachelor’s degree