Senior Manager, Stop Loss & Health Claims
Core
Leads complex claims operations, overseeing evaluation, investigation, negotiation, and settlement of medical stop-loss and health insurance claims.
Role type
Senior Manager, Claims Operations
Builds
Efficient claims processing workflows and customer service excellence
Domain
Health Insurance / Stop-Loss Insurance
Required skills
Medical stop-loss insurance expertise, Health insurance claims management, Team leadership, Claims operations management, Stakeholder management, Analytical problem-solving, Knowledge of state/federal claims laws, Claims management systems proficiency
Preferred skills
Management/leadership experience, Deep industry expertise, Communication and negotiation skills, Data analysis
Responsibilities
Direct evaluation, investigation, negotiation, and settlement of complex claims; Supervise, mentor, and grow a talented claims team; Monitor workflow and implement efficiencies; Collaborate with third-party administrators, brokers, agents, and legal counsel