Stop Loss Claims Examiner

Posted on 9/26/2023

INACTIVE

201-500 employees

Provides comprehensive health benefits to SMEs

Company Overview

Gravie stands out as a rapidly expanding health benefits company, providing comprehensive health plans that fully cover common healthcare services, a unique offering in the market. Their focus on small and midsize employers, a sector often overlooked by traditional health plans, demonstrates their commitment to filling a gap in the industry. Furthermore, their research into dedicated support for the growing interest in Individual Coverage Health Reimbursement Arrangements (ICHRA) indicates their proactive approach to evolving healthcare needs.

Financial Services

Company Stage

Private

Total Funding

$342.6M

Founded

2013

Headquarters

Minneapolis, Minnesota

Growth & Insights

Headcount

6 month growth

↑ 25%

1 year growth

↑ 62%

2 year growth

↑ 65%

Locations

Minneapolis, MN, USA

Experience Level

Entry

Junior

Mid

Senior

Expert

Desired Skills

Customer Service

Communications

CategoriesNew

Medical, Clinical & Veterinary

Customer Success & Support

Requirements

Bachelor's Degree or equivalent work experience
5 + years of substantial experience in processing Medical Claims
Working knowledge of insurance terminology and medical coding
Demonstrated problem-solving, organizational, and analytical skills
Excellent communication skills
Ability to work independently, prioritize workloads, and multi-task

Responsibilities

Examine and evaluate Specific Stop Loss claim submissions according to Stop Loss Claims procedures and methodology
Ensure that Stop Loss Claims are paid correctly under the terms of the Stop Loss Policy and Underlying Plan
Communicate payment and denial decisions in a clear and professional manner
Appropriately escalate difficult issues up the chain of command
Provide outstanding customer service and collaborate with other departments, management, and external partners
Demonstrate commitment to our core competencies of being authentic, curious, creative, empathetic and outcome oriented

Hi, we’re Gravie. Our mission is to improve the way people purchase and access healthcare through innovative, consumer-centric health benefit solutions that people can actually use. Our industry-changing products and services are developed and delivered by a diverse group of unique people. We encourage you to be your authentic self - we like you that way.

We’re looking for a Stop Loss Claims Examiner to join our team. The primary responsibilities for this position include reviewing and paying Stop Loss claims accurately and awesomely for a quickly growing and innovative insurance company..

You will:

• Examine and evaluate Specific Stop Loss claim submissions according to Stop Loss Claims procedures and methodology

• Ensure that Stop Loss Claims are paid correctly under the terms of the Stop Loss Policy and Underlying Plan

• Communicate payment and denial decisions in a clear and professional manner

• Appropriately escalate difficult issues up the chain of command

• Provide outstanding customer service and collaborate with other departments, management, and external partners

• Demonstrate commitment to our core competencies of being authentic, curious, creative, empathetic and outcome oriented.

You bring:

• Bachelor’s Degree or equivalent work experience

• 5 + years of substantial experience in processing Medical Claims

• Working knowledge of insurance terminology and medical coding

• Demonstrated problem-solving, organizational, and analytical skills

• Excellent communication skills

• Ability to work independently, prioritize workloads, and multi-task

Extra credit:

• Previous experience with Stop Loss claims

Competitive pay is standard. Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation package apart. In addition to standard benefits, Gravie’s package includes alternative medicine coverage, flexible PTO, 16 weeks paid parental leave, paid holidays, cell phone reimbursement, education reimbursement, and 1 week of paid paw-ternity leave just to name a few.