Stop Loss Coordinator

Job title: Stop Loss Coordinator

Company: BlueCross BlueShield Of South Carolina

Job description: Summary

As the Stop Loss Coordinator, you will be responsible for handling the inbox of all claims that will need to be audited. This process consists of logging them in the system, providing reinsurance support for new and renewal business, underwriting and other functions, conducting weekly/monthly reports and some letter writing under the direction of the TPA Claims Director.



This is a full-time position working (40-hours/week) Monday-Friday 8:00am – 4:30pm.

This position is a remote position with the United States. There will be occasional (2-4 occasions) travel in this role.

What You’ll Do:

  • Processes mail, email, and faxes to maintain departmental productivity, quality and timeliness standards. May assist in preparing various financial data associated with refunds, recoupments, adjustments, and reissues, and ensure appropriate documentation for each refund request and associated payment. Maintains logs. Assists in processing/providing routine premium billing statements and/or various reports. Maintains filing systems.
  • Coordinates communication of information between reinsurance companies and various internal and external areas. Reviews documentation for completeness, and may rate new business, order required reports within timeliness standards, determine benefits, issue new policies, and/or report surplus lines taxes. Requests additional information when needed within timeline standards. Accurately documents process changes.
  • Checks status of claims or notices and may service existing accounts by processing endorsements/amendments, identifying problems, and responding to inquiries. May review disbursement requests for large case management claims and other specific diagnosis codes, and forward to claims for detailed review.
  • Ensures effective customer relations by responding accurately, timely, and courteously to telephone or written customer inquiries. Accurately documents inquiries.

To Qualify for This Position, You’ll Need:

  • High School Diploma or equivalent
  • 1 year customer service or administrative experience.
  • Microsoft Office (Outlook, Word, Excel, etc.) experience

We Prefer That You Have:

  • Associate Degree-Business Administration or related field

What We can Do for You:

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.

  • Subsidized health plans, dental and vision coverage
  • 401K retirement savings plan with company match
  • Life Insurance
  • Paid Time Off (PTO)
  • On-site cafeterias and fitness centers in major locations
  • Wellness program and healthy lifestyle premium discount
  • Tuition assistance
  • Service recognition
  • Employee Assistance
  • Discounts to movies, theaters, zoos, theme parks and more

What to Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure your meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. If the qualifications required proof of semester hours, please attach your transcript to your application.

Management will be conducting interviews with the most qualified candidates, with prioritization give to those candidates who demonstrate the preferred qualifications.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains Affirmative Action programs to promote employment opportunities for minorities, females, disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities.

If you need special assistance or an accommodation while seeking employment, please e-mail or call 1-800-288-2227, ext. 43172 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

Expected salary:

Location: South Carolina

Job date: Fri, 05 Aug 2022 07:32:32 GMT

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