Claims Examiner, Medical Stop Loss

Job Description: • 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 Apply tot his job