Do you want to use your experience and knowledge of stop loss insurance documentation support and reimbursement? Join our team and our growing organization with your critical thinking skills and leadership.

Roll Summary:

The Stop Loss Supervisor Assistant is responsible for managing the daily processes of the department including initial submission of a stop loss claim with all supporting documentation, subsequent submissions of each claim, monitoring reports, researching reimbursement shortages, frequent contact with carriers, clients, brokers, vendors and internal staff including Marketing, Claims and Accounting. This position will report to the Stop Loss Manager. Identified gaps should be identified and corrected. The ability to pivot to absorb increasing inventories, set weekly priorities and reassign as needed to keep up with workloads and daily requirements. Provide clear instruction regarding expectations and priorities of the week is vital to keep inventories in check.

Responsibilities:

• Use your experience and our comprehensive training to manage excess loss claim documentation and reimbursement.
• Build relationships and ask the right questions.
• Create or revise procedures to correct gaps on process details or corrects process data requirement
• Collaborate with peers to ensure consistency in processes
• Communicate with internal and external customers, clients, stop loss carriers and vendors to gather information pertaining to Stop Loss.
• Respond to various written and telephone inquiries for eligibility, approval/denial determinations, and claim status.
• Juggle multiple tasks without sacrificing deadlines or attention to detail.
• Oversee daily function of the Stop Loss staff.

Minimum Qualifications:

• High School Diploma or GED
• Basic computer experience and extensive knowledge of the company’s claims process and claims software
• 3+ years excess loss/stop loss experience.
• Excellent oral and written communication skills
• Ability to prioritize problems and responsibilities.
• Extensive knowledge of medical terminology, procedures and health insurance concepts.
• Ability to understand plan document language accurately as it applies to benefits and apply rules, regulations and plan provisions to specific situations.
• High level of interpersonal skills to work effectively with others.
• Ability to manage time and job duties without daily supervision.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 56,200 - 93,600 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here.

About Cigna Healthcare:

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: See Yourself@cigna.com for support. Do not email See Yourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.