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Stop Loss Claims Examiner

Gravie

Gravie

Minneapolis, MN, USA
Posted on Thursday, August 10, 2023
Hi, we’re Gravie. Our mission is to improve the way people purchase and access healthcare through innovative, consumer-centric health benefit solutions that people can actually use. Our industry-changing products and services are developed and delivered by a diverse group of unique people. We encourage you to be your authentic self - we like you that way.
We’re looking for a Stop Loss Claims Examiner to join our team. The primary responsibilities for this position include reviewing and paying Stop Loss claims accurately and awesomely for a quickly growing and innovative insurance company..
You will:
Examine and evaluate Specific Stop Loss claim submissions according to Stop Loss Claims procedures and methodology
Ensure that Stop Loss Claims are paid correctly under the terms of the Stop Loss Policy and Underlying Plan
Communicate payment and denial decisions in a clear and professional manner
Appropriately escalate difficult issues up the chain of command
Provide outstanding customer service and collaborate with other departments, management, and external partners
Demonstrate commitment to our core competencies of being authentic, curious, creative, empathetic and outcome oriented.
You bring:
Bachelor’s Degree or equivalent work experience
5 + years of substantial experience in processing Medical Claims
Working knowledge of insurance terminology and medical coding
Demonstrated problem-solving, organizational, and analytical skills
Excellent communication skills
Ability to work independently, prioritize workloads, and multi-task
Extra credit:
Previous experience with Stop Loss claims
Competitive pay is standard. Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation package apart. In addition to standard benefits, Gravie’s package includes alternative medicine coverage, flexible PTO, 16 weeks paid parental leave, paid holidays, cell phone reimbursement, education reimbursement, and 1 week of paid paw-ternity leave just to name a few.