[Hiring] Trainer Stop Loss Claims @Brown & Brown Insurance

Role Description

The incumbent is responsible for providing training for newly hired Specific Stop Loss claims auditors and refresher training for all Specific Stop Loss claims auditors.

• Develop a training curriculum with all necessary materials/documentation, covering all aspects of specific stop loss claims including, but not limited to:
• Logging claims
• Preparing working copies
• System line-item data entry
• Completing claim checklists and examining all claim details
• Pending and/or releasing payments
• Pend follow up and correspondence handling
• Establish an objective measuring tool for tracking trainee progress or lack thereof.
• Train all new specific stop loss claim auditors to determine whether they have successfully completed the training program and are ready to be placed in production with their team.
• Serve as a subject matter expert for an assigned claims team and provide technical guidance related to specific stop loss claims to the team.
• Review and analyze Specific Stop Loss claims referred by auditors or as requested by clients and assist with over authorization reviews.
• Audit Specific Stop Loss claims during peak periods.
• Ensure continuous process improvement opportunities are reviewed and implemented, as appropriate.
• Contribute innovative ideas and assist with the implementation of new processes.

Qualifications

• 3-5 years of Specific Stop Loss Claim experience.
• Prior Team Lead or Management experience in stop loss claims to include experience with quality assurance.
• Prior experience with industry repricing methodologies (PPO, Wrap Networks, Reference Based Pricing, etc.).
• Demonstrated proficiency in Microsoft Office, including Microsoft Outlook.
• Demonstrated strong analytical/critical thinking skills; and detail-oriented focus.
• Strong written and verbal communication skills.
• Ability to work independently with minimal supervision.

Requirements

• Prior experience auditing aggregate stop loss claims.
• History of successful Process Improvement initiatives.
• Prior experience leading a team or managing processes.

Benefits

• Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance.
• Financial Benefits: ESPP; 401k; Student Loan Assistance; Tuition Reimbursement.
• Mental Health & Wellness: Free Mental Health & Enhanced Advocacy Services.
• Beyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts and more.