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Hub International Stop Loss Claims Manager in Atlanta, Georgia

About SPG:

Specialty Program Group (SPG) is the wholesale & MGA division of HUB International (5th Largest Global Broker). SPG acts in a holding company capacity acquiring best in class underwriting businesses to operate independently under discrete brands (portfolio companies).

Strategic Benefit Resources provides complete facilitation of specific and aggregate stop loss claims. Our comprehensive approach begins with a thorough review of the claims submission and ends with an expedited and accurate reimbursement.

Responsibilities:

• Exhibits an attention to detail and a strong work ethic.

• Exhibits the ability to access and utilize research tools for accurate claims entry.

• Ability to read and understand reinsurance contracts and Summary Plan Descriptions.

• Possesses good organizational skills and can manage time and resources effectively and efficiently.

• Possesses a thorough knowledge of coding structures (CPT, HCPCS, UB/Revenue codes, ICD 9/10 etc.)

• Ability to perform arithmetic calculations.

• Good understanding of benefits and benefit calculations.

• Performs duties in a HIPAA compliant manner.

• Participates as a team member to ensure the smooth operation of the entire department.

• Maintains guidelines and notes with detail to enable accurate stop loss filings for reimbursement to the group.

• Maintains Turnaround Time (TAT) guidelines and accuracy goals with filing of Aggregate and Specific stop loss claims.

• Files stop loss claims - initial, subsequent and/or final filings, making sure all necessary documentation is included and submitted in a timely manner.

• Reviews accuracy of claims included with reimbursement requests to prevent additional delay once the reinsurance claim has been received by the carrier.

• Maintenance of stop loss claims information in Salesforce.

• Troubleshoot claim issues as needed.

• Develops and maintains relationships with the various brokers, carriers and contacts at the clients.

• Complies with departmental policies and procedures.

• Assists in training/mentoring of other employees at the Supervisor or Manager’s request to ensure consistency within the stop loss department.

• Performs special projects at the request of Management.

• Demonstrates the ability to complete root cause analysis and develop process improvement plans to present to Management.

• Advanced proficiency and experience using Microsoft Office software and familiarity with Salesforce is a plus.

Qualifications:

• Bachelor’s degree and two years’ experience with stop loss claims management or equivalent

combination of education and experience.

Disclosure required under applicable state or municipality regulations: The expected salary range for this position is $60,000 to $65,000 and will be impacted by factors such as the successful candidate’s skills, experience and working location, as well as the specific position’s business line, scope and level. HUB International is proud to offer comprehensive benefit and total compensation packages which could include health/dental/vision/life/disability insurance, FSA, HSA and 401(k) accounts, paid-time-off benefits, and eligible bonuses, equity and commissions for some positions.

Department Account Management & Service

Required Experience: 2-5 years of relevant experience

Required Travel: Negligible

Required Education: Bachelor's degree (4-year degree)

HUB International Limited is an equal opportunity and affirmative action employer that does not discriminate on the basis of race/ethnicity, national origin, religion, age, color, sex, sexual orientation, gender identity, disability or veteran's status, or any other characteristic protected by local, state or federal laws, rules or regulations. The EEO is the Law poster and its supplement is available here at http://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm .

EEOAA Policy (https://hubinternational.jobs/eeo/)

E-Verify Program

We endeavor to make this website accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the US Recruiting Team toll-free at (844) 300-9193 or USRecruiting@hubinternational.com . This contact information is for accommodation requests only; do not use this contact information to inquire about the status of applications.

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