Manager, Stop Loss Accommodations
Apply NowCompany: Assured Benefits Administrators
Location: Dallas, TX 75217
Description:
POSITION SUMMARY
The Manager of Stop Loss Accommodations will be responsible for tracking, filing and receiving the group-level accommodations required under the stop loss contracts.
DUTIES AND RESPONSIBILITIES
The essential functions include, but are not limited to the following:
MINIMUM QUALIFICATIONS (KNOWLEDGE, SKILLS, AND ABILITIES)
TO ALL RECRUITMENT AGENCIES: The Company and its affiliates do not accept unsolicited agency resumes or inquiries. Please do not reach out regarding any of our job postings, careers sites, or send inquiries to any employees of the Company or its affiliates. We are not responsible for any fees related to unsolicited resumes.
The Manager of Stop Loss Accommodations will be responsible for tracking, filing and receiving the group-level accommodations required under the stop loss contracts.
DUTIES AND RESPONSIBILITIES
The essential functions include, but are not limited to the following:
- Analytical responsibilities to capture monthly accommodation requirement for level funded groups that have exceeded their available claims fund.
- Design processes to capture all necessary information for stop loss requests in accordance with carrier requirements.
- Proactively ensure all required documentation needed to satisfy policy requirements has been made available prior to claim filing.
- Develop automation to allow for transmission of data to occur efficiently and accurately between re-insurance partners.
- Develop tracking process to follow up and close gaps that may exist on claims submissions.
- Escalate process delays to management that could cause execution problems for the timely payment of claims.
- Define a process to capture and include PBM claims, medical management claims and other non-medical claims that should be included in filings.
- Create relationships with stop-loss partners that allow for effective communication and promote efficient processes.
- May perform other duties as required.
MINIMUM QUALIFICATIONS (KNOWLEDGE, SKILLS, AND ABILITIES)
- Bachelor's degree or an equivalent combination of education and experience
- Must have a minimum of six years of leadership experience with a strong knowledge of the self-insurance market.
- Excellent organizational and project management skills.
- Must be able to communicate across multiple teams and levels of the organization.
TO ALL RECRUITMENT AGENCIES: The Company and its affiliates do not accept unsolicited agency resumes or inquiries. Please do not reach out regarding any of our job postings, careers sites, or send inquiries to any employees of the Company or its affiliates. We are not responsible for any fees related to unsolicited resumes.