Marpai Administrators is a technology company transforming the Third-Party Administration sector serving employers with self-funded health plans. Marpai Administrators (“Marpai”) is an AI-powered national TPA (third party administrator) using deep learning and machine learning to maximize population health outcomes with the greatest cost efficiency for any health plan budget. We create healthier members and a healthier bottom line. Marpai proactively targets at-risk members with meaningful clinical interventions to improve outcomes.
ABOUT THE POSITION:
The Stoploss Manager works directly with Stop Loss Carriers and MGUs to understand their needs and then collaborates with IT to deliver required reporting. This position reports to the Senior Director of claims and eligibility.
WHAT YOU WILL BE DOING: ·
Manage the Stop Loss team to include day-to-day functions including workflow and performance management. Design and implement policies and procedures to optimize corporate directives and strategy
Oversee the filing of specific and aggregate claims, ensuring all reimbursements are accurately calculated and received. Perform weekly audits of specific claims to verify filling accuracy
Strong ability to read stop loss contracts
Analyze reports to determine data integrity issues and provide solutions
Prepare monthly, quarterly and year end reports on claim statuses, financial exposure and savings.
Develop relationships with Stop Loss Carriers and MGUs that foster trust and collaboration.
Run reports to analyze data and identify anomalies
Acts as liaison between Stop Loss Carriers and MGUs and the Account management team.
Other duties as required
WHAT DO YOU NEED
Highly organized and capable of focusing on problem details
2+ years of experience with Reinsurance
Strong time management skills and ability to multi-task
Advanced skills with Microsoft Office products including MS Word, MS Excel or equivalent
Energetic and motivated
Work with minimum supervision
Work cooperatively with people at all levels with respect and demonstrate the ability to respond appropriately in a variety of complex situations
Extensive knowledge of functional tasks performed within his/her department
Working knowledge of computers and related software packages
Demonstrate excellent organizational skills
Demonstrate excellent verbal and written communication skills, leadership and decision-making skills
Prioritize, research and make timely decisions
Demonstrate strong analytical skills and ability to report findings in an accurate manner
WORK REQUIREMENTS:
Fast paced, dynamic work environment requiring the ability to be adaptive, innovative and flexible
Travel minimal
WHY WORK AT MARPAI?
We have great benefits:
Generous PTO
Medical and Prescription
EAP
FSA / HSA / Dependent Care
Dental
Vision
Life and Disability
STD/LTD
Voluntary Benefits: Critical Illness, Accident, Hospital
401k with Employer Match
LegalShield
Identity Theft Protection
Marpai is an equal opportunity workplace. We are committed to equal opportunity regardless of race, color, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, or veteran status.
This is a remote position.