Stop Loss Claims Analyst/Risk Management Specialist - Remote

Overview

Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Stop Loss Claims Analyst/Risk Management Specialist, you’ll play an important role in helping us offer customized, self-funded insurance options to our clients and members.

In Short

• Track & Report: Identify and report members who meet 50% or more of the specific deductible to our excess loss vendor.
• Data Management: Collect and submit all required documentation to request reimbursement for claims that exceed the specific deductible.
• Claim Processing: Review daily funding requests, track paid claims, and manage eligible claims submissions for stop-loss and advanced funding requests.
• Communication & Coordination: Act as the liaison between the excess loss vendor and internal teams, providing necessary data and responding to vendor inquiries.
• Audit & Reporting: Assist with monthly and year-end aggregate claim submissions and support internal audits by providing necessary information.

Requirements

• Education & Experience: associate's degree or 2+ years of relevant work experience.
• Proficiency in MS Office: Solid experience with Microsoft Word, Excel, and Outlook.
• Industry Knowledge: Familiarity with healthcare claims, stop-loss insurance, and medical terminology is a plus.
• Highly Organized: Able to manage multiple tasks efficiently in a fast-paced environment.
• Analytical Mindset: Strong mathematical skills are essential for tracking claims and preparing reimbursement requests.
• Attention to Detail: You'll be responsible for managing high-cost claims, so accuracy is key.
• Team Player: Ability to work collaboratively across multiple departments and communicate effectively.
• Industry Experience: A background in accounting, medical billing, or banking is helpful, as well as familiarity with medical terminology. Experience with third-party administrators (TPAs) or health insurance carriers is strongly preferred.

Benefits

• Fantastic medical, dental, and vision insurance*
• Twice annual employer HSA contributions, covering 50% of the HDHP plan’s annual deductible!
• Company provided Basic Life and AD&D
• Company paid Short-Term and Long-Term Disability**
• Flexible Spending Accounts*
• 401(k) Retirement Plan with up to a 6% employer-match** WOW! (100% fully vested after 3 years)
• 10+ paid holidays
• Generous paid vacation and sick time
• Annual Volunteer Paid Day
• Annual Tuition Reimbursement
• Annual Health and Wellness Reimbursement
• Lots of fun company events