Job Description:

S top-loss Job Tasks

This position is responsible for thorough evaluation of all submitted claims to ensure appropriate reimbursement of Stop Loss claims.

Responsibilities:

•Analyzing claims to ensure all necessary documentation has been received and criteria are met for reimbursement, including evaluation of appropriate billing, member eligibility, contracts and plan specifications.

•Coordinating with various departments to ensure that all cost containment initiatives are executed, and appropriate case management is engaged.

•Initiating claim reimbursement to self-funded clients

#electHealth

Minimum Qualifications

• Demonstrated project coordination experience managing complex, multi-scope projects

• Demonstrated advanced level experience with computer system applications including spreadsheet, word processing and database applications and demonstrated analytical, organizational and communication skills.

• Demonstrated experience supporting a leadership or department team

• Demonstrated excellent interpersonal skills with internal and external senior-level leaders

• Demonstrated proficient time management, ability to prioritize and flex work to align with business operational priorities

• Demonstrated ability to exercise sound judgement and professional behavior while acting decisively

• Demonstrated organizational and problem-solving skills with high attention to detail

• Demonstrated ability to work efficiently and effectively in an independent manner

• Demonstrated verbal and written communication skills including discernment, spelling, punctuation, and grammar

• Demonstrated experience managing remote and in-person meetings

Preferred Qualifications

• Bachelor's degree. Degree must be obtained through an accredited institution, which will be verified.

• Experience working in a matrixed healthcare or health insurance setting

Physical Requirements:

Anticipated job posting close date:

06/24/2024

Location:

SelectHealth - Murray

Work City:

Murray

Work State:

Utah

Scheduled Weekly Hours:

40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$26.45 - $41.66

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/) , and for our Colorado, Montana, and Kansas based caregivers (http://www.sclhealthbenefits.org) ; and our commitment to diversity, equity, and inclusion (https://intermountainhealthcare.org/careers/working-for-intermountain/diversity/) .

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.