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.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)
