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Stop Loss Claims Analyst
Location:
Phoenix, AZ
Description:
Hawaii Mainland Administrators, LLC is a privately held, national Healthcare company which provides a broad range of development, management and information services. Full time employment has career growth opportunities, life insurance, paid Holidays, PTO and many more great benefits. Hawaii Mainland Administrators, LLC (HMA, LLC) is seeking a full time Stop Loss Claim Analyst for our Tempe, AZ location. The prospective candidate will need excellent oral and written communications. They should have the ability to maintain a courteous and professional demeanor while working under pressure, self-starter with the ability to work independently and as part of a team, detail oriented, strong analytical ability. Hourly position with 401(k), paid Holidays and excellent company paid benefits. Candidates should submit your resume and wage requirements to [XXXX@hmatpa.com] or fax to 866-293-XXXX. Education Required Associates Degree or Equivalent/Relevant Work Experience Experience Required Prior Stop Loss and claims processing experience: Strong knowledge of ICD-10 Coding, CPT codes, member eligibility and claim payment terminology. Knowledge and comprehension of Stop Loss policies, SPD, FMLA, COBRA, and eligibility. Ability to understand contract language/employee summary plan documents; Ability to multitask, work independently, and adhere to deadlines in a fast-paced environment. Ability to analyze claim submissions for errors or omitted information. Excellent communication and organizational skills. Proficient Excel/Word/Outlook skills. Job Purpose This position will be part of team managing a run-out block of business for potentially a year and then will transition to the HMA internal Stop Loss team. Work with the Finance Department and the assigned Independent Fiduciary to ensure HMA has fulfilled all responsibilities for Stop Loss recoveries in an effort to obtain maximum Stop Loss reimbursement and to close the groups out from their previous Stop Loss contracts. Main Duties and Responsibilities File specific and aggregate claims for stop loss recoveries. Create and analyze specific and aggregate reports required by Stop Loss Carrier/MGU. Review current and previous stop loss filings for accuracy, MGU reimbursement methodology, current status inquiries, collect any additional requested documents and submit appeals. Respond to broker, attorney and group inquiries on claim status. Complete tasks with accuracy and close attention to detail. Pay close attention to detail, and the ability to effectively prioritize daily activities to adhere to time sensitive tasks.
Company:
Hawaii Mainland Administrators
Posted:
December 26 2023 on ApplicantPro
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More About this Listing: Stop Loss Claims Analyst
Stop Loss Claims Analyst is a Jobs Analyst Job at Hawaii Mainland Administrators located in Phoenix AZ. Find other listings like Stop Loss Claims Analyst by searching Oodle for Jobs Analyst Jobs.
Stop Loss Claims Analyst is a Jobs Analyst Job at Hawaii Mainland Administrators located in Phoenix AZ. Find other listings like Stop Loss Claims Analyst by searching Oodle for Jobs Analyst Jobs.