The Supervisor, Stop Loss Claims will lead a team responsible for processing stop loss claims, ensuring quality, training, and efficiency in claims management.
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.
A Little More About the Role:
We’re looking for a Supervisor, Stop Loss Claims to join our team. The primary responsibility for this position is leading the team of Claims Examiners responsible for reviewing submissions of stop loss-eligible claims from Gravie’s health plans.
You will:
● Supervise Gravie’s Stop Loss Team to ensure timely and accurate processing of stop loss claims generated by Gravie’s level and self-funded health plans ensuring necessary team, department and network goals are met
● Oversee Stop Loss inventory, daily work assignment and adjudication of stop loss claims
● Ensure that claims are paid correctly under the terms of the Stop Loss Policy and all applicable Plan Documents
● Regularly review audit and quality data performed by Stop Loss Claims Examiners to ensure that internal standards for quality are being met
● Maintain productivity standards for key volume-driven tasks (i.e Stop Loss Submissions completed per hour.) to ensure SLA’s and department goals are consistently met
● Track productivity by task to ensure budgeted capacity is adequate to meet supply and demand
● Participate in the administration and oversight of Gravie’s stop loss administration software system and work together with configuration to assist with system enhancements
● Serve as a stop loss subject matter expert and act as a go-to resource for the team
● Support team members in reaching their full potential by providing coaching, sharing expertise, best practices, offering constructive feedback for improvement, and celebrating accomplishments.
● Collaborate with other departments, management, and external partners
● Demonstrate commitment to our core competencies of being authentic, curious, creative, empathetic and outcome oriented
● Play a key role in the development of departmental workflows and improvements to existing processes
● Facilitate department-specific training, new hire training and ongoing education to support team development and knowledge retention
You bring:
● Bachelor’s Degree or equivalent work experience
● 3 to 5 years of Stop Loss Claims experience
● Demonstrated problem-solving, organizational, and analytical skills
● Excellent communication skills
● Technological fluency and ability to quickly learn new systems and technologies
● Ability to work independently, prioritize workloads, and multi-task
Extra credit:
● Previous experience at a high growth company
Gravie:
In order to transform health insurance and build a health plan everyone can love, we need talented people doing amazing work. In exchange, we offer a great overall employee experience with opportunities for career growth, meaningful mission-driven work, and an above average total rewards package.
The salary range for this position is $69,150 - $115,250 annually. Numerous factors including, but not limited to, educations, skills, work experience, certifications, etc. will be considered when determining compensation.
Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation package apart. In addition to standard health and wellness benefits, Gravie’s package includes alternative medicine coverage, flexible PTO, up to 16 weeks paid parental leave, paid holidays, a 401k program, cell phone reimbursement, transportation perks, education reimbursement, and 1 week of paid paw-ternity leave.
A Little More About Us:
● We know healthcare. Our company was founded and is still led by industry veterans who have started and grown several market-leading companies in the space.
● We have raised money from top tier investors who share the same long-term vision as we do of building an industry defining company that will endure over the long run. We are well capitalized.
● Our customers like us. Our revenue churn is in the low single digits, in an industry where greater than 20% churn is common.
● Our culture is unique. We tend to be non-hierarchical, merit-driven, opinionated but kind people who thrive working in a high-performance, fast-paced environment. People at Gravie care deeply about making a positive impact in the lives of the people we serve. We may not be the right place for everybody, but if you get energized by doing work every day that focuses on putting consumers at the front of the line, we could be a great place for you. It takes unique people and diverse perspectives to deliver our results. We encourage you to be your authentic self – we like you that way.
Top Skills
Stop Loss Claims Administration Software
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