Claims Program Manager
remoterocketship
- New York, New York, United States
- New York, New York, United States
À propos
Assist in the creation of a relationship-based culture through a broad set of activities which include managing a diverse portfolio of medical products and administrators on an ongoing basis Serve as a “next-step” liaison to administrative, operations, and underwriting areas of the company, on an ongoing basis Utilize sensitivity tactics to address relevant issues with distressed customers in a professional manner, on an ongoing basis Participate in team member’s meetings with clients and address all open issues no less often than quarterly Address technical issues and coordinate with IT team to seek resolutions as needed Assist with the Program Management Team’s onboarding of new clients as needed Establish long term customer relationships through prompt and courteous service Assist in Due Diligence of new program administration business, which includes onsite reviews and assessment, while providing Management an operational assessment of prospective partners Conduct annual reviews of administrators to ensure compliance with company requirements, while identifying gaps in process and/or areas for potential improvement at both the administrator and company level Monitor claims activity to identify any outliers, no less often than quarterly Prepare monthly reporting packages, including but not limited to, inventory reporting, first level (TPA customer service & turnaround) statistics, and referral analysis (turnaround times, volume breakdowns) for review by VP / AVP / Director and Senior Level Management Assist with the monthly analysis of all claims related litigation/regulatory inquiries and/or high dollar claims to identify all trends and exposure Assist in the drafting and maintenance of reference documents for internal Claims Best Practices including: Standards – both C&F and regulatory, Procedures, Workflow Requirements:
Bachelor’s Degree from an accredited university/institution 6+ years’ experience of relevant Medical Stop Loss or Medical Excess Experience Experience in specialty products such as Employer Stop Loss, Short Term Medical, Medical Excess, Fixed Indemnity, and Life is preferred Strong knowledge of Microsoft Office tools – Outlook, Excel, Word and PowerPoint Ability to work in a fast-paced environment and adaptable Ability to travel (up to 40%) 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
Compétences linguistiques
- English
Avis aux utilisateurs
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