EDUCATION
High School Diploma or equivalent.
Bachelor’s degree in Business, Math, Finance, Accounting, Statistics, Economics, Health Administration, Informatics, Health Information or related field. In lieu of degree, five (5) years' non-clerical healthcare industry experience will be considered.
LICENSING/CERTIFICATION
Arkansas state Health/Life insurance license required within 6 months of date of hire.
EXPERIENCE
Training through industry courses and seminars such as HIAA, FLMI, CHC, CEBS etc. preferred.
Knowledge of medical risks, conditions, treatments, pharmacology, and medical terminology preferred.
Additional preferred experience:
Strong understanding of stop loss insurance concepts (specific and aggregate) Experience reviewing high-dollar medical claims for stop loss reimbursement. Ability to interpret and apply stop loss contracts, including exclusions, lasers, deductibles, and contract provisions.
Proven ability to analyze plan documents, stop loss policies, and amendments.
Experience working with TPAs, brokers, Sales representatives, and finance teams.Ability to explain complex claim or contract issues to non technical audiences.
***This position requires 3 days in the office, Tuesday-Thursday***
ESSENTIAL SKILLS & ABILITIES
Mathematical
Analytical
Problem/Situation Analysis
Decision-Making
Detail-Oriented
Excellent communication & interpersonal skills
Excellent computer skills
This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.
Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.
ADA Requirements
2.1 General Office Worker, Semi-Active, Campus Travel - Someone who normally works in an office setting or remotely, periodically has lifting and carrying requirements up to 40 lbs and routinely travels for work within walking distance of location of primary work assignment as essential functions of the job.