What are the responsibilities and job description for the Stop Loss Specialist position at Mashantucket Pequot Tribal Nation?
Under the direction of the Auditing Supervisor, the Stop Loss Specialist is responsible for the oversight, tracking, and claims administration for stop loss insurance for all clients of the Pequot Plus Health Benefit Services including MPTN. The incumbent will identify potential carriers, coordinate TPA authorization as a recognized claims processor and act as coordinator of all reinsurance activities on behalf of the clients. This position works to support Account Executives and Account Managers in servicing clients. High school diploma or general education degree (GED); knowledge of medical coding required; certification from medical office training preferred; three years claims processing experience preferred; experience and/or knowledge in stop loss insurance; proficiency in computer skills necessary; ability to learn specialized computer programs.
