Claims and Implementation Specialist
New
J
JobgetherHealthcare Benefits
Based in United StatesFull-TimeMiddle
Salary$65,000–$70,000
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Job Details
- Experience
- 2–5 years
- Required Skills
- Project ManagementMicrosoft ExcelStakeholder management
Requirements
- 2–5 years of experience in employee benefits, health insurance, stop loss, third-party administration, captive programs, implementation, account management, or project coordination.
- Bachelor’s degree preferred.
- Knowledge of self-funded health plans, claims administration, and reimbursement processes preferred.
- Intermediate to advanced Microsoft Excel skills.
- Strong project management and organizational skills.
- Excellent verbal and written communication skills.
- Strong presentation and stakeholder management abilities.
- Current Life & Health Insurance License or ability to obtain within 90 days of hire.
- Ability to manage confidential and sensitive information appropriately.
- Proactive problem-solving skills and detail-oriented approach.
Responsibilities
- Manage implementation activities for new stop loss, captive, level-funded, and self-funded benefit programs.
- Develop, maintain, and monitor implementation schedules, project plans, and key milestones.
- Coordinate onboarding efforts between employers, consultants, third-party administrators, carriers, and vendor partners.
- Facilitate implementation meetings and provide timely updates on project progress.
- Ensure completion and submission of required documentation, contracts, and enrollment materials.
- Monitor claims activity, report threshold-exceeding members, and process eligible reimbursement requests.
- Maintain accurate claims records, tracking systems, and company databases.
- Identify process improvements to enhance operational efficiency and client experience.
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