Stop Loss Claims Supervisor

Remote

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Not SpecifiedCompensation

Junior (1 to 2 years), Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Health Insurance, Employee Benefits, InsuranceIndustries

Requirements

Candidates should possess a Bachelor's Degree or equivalent work experience, with 3 to 5 years of Stop Loss Claims experience. Demonstrated problem-solving, organizational, and analytical skills are essential, along with excellent communication and technological fluency. The ability to work independently, prioritize workloads, and multitask is also required.

Responsibilities

The Stop Loss Claims Supervisor will lead a team of Claims Examiners in the timely and accurate processing of stop loss-eligible claims, ensuring adherence to policy terms and plan documents. Responsibilities include overseeing inventory, daily work assignment, adjudication, and quality audits to meet internal standards and productivity metrics. The role involves participating in the administration of stop loss software, acting as a subject matter expert, coaching team members, collaborating with other departments, and contributing to the development of departmental workflows and training.

Skills

Stop Loss Claims

Team Supervision

Claims Examination

Audit & Quality Data

Adjudication

Productivity Tracking

Stop Loss Submissions

Stop Loss Administration Software

System Configuration & Enhancements

Subject Matter Expert

Gravie

Health benefits and insurance solutions provider

About Gravie

Gravie provides health benefits by offering straightforward and affordable health plans, primarily targeting individuals and small to midsize businesses. Their main product, Comfort, stands out because it has no deductible and no copays for most common healthcare services, allowing members to access care without unexpected costs. Additionally, Comfort includes virtual care options for musculoskeletal and mental health issues. Gravie also offers a payment solution called Gravie Pay, which enables members to pay for healthcare expenses interest-free, further easing financial stress. Unlike traditional health plans, Gravie claims that Comfort members save on out-of-pocket costs, and employers switching to Gravie often see lower premium expenses. The company has a high retention rate, indicating that many employees choose to continue with the Comfort plan in subsequent years. Gravie's goal is to simplify health benefits and reduce the financial burden of healthcare for its members.

Minneapolis, MinnesotaHeadquarters

2013Year Founded

$333.3MTotal Funding

DEBTCompany Stage

Fintech, HealthcareIndustries

201-500Employees

Benefits

Health Insurance

401(k) Retirement Plan

401(k) Company Match

Paid Holidays

Paid Vacation

Paid Sick Leave

Flexible Work Hours

Paid Parental Leave

Wellness Program

Alternative Medicine Coverage

Cell Phone Reimbursement

Transportation Perks

Education Reimbursement

Paid Paw-ternity Leave

Risks

Potential backlash from traditional insurers could increase competition or lobbying.

Rapid ICHRA adoption may invite regulatory scrutiny or changes.

Aggressive expansion strategy could strain resources and lead to inefficiencies.

Differentiation

Gravie's Comfort plan offers zero deductibles and copays, unlike traditional health plans.

Gravie Pay provides interest-free payment solutions, reducing financial burdens for members.

Focus on virtual healthcare services enhances accessibility and member satisfaction.

Upsides

Increased ICHRA adoption since 2020 expands Gravie's market opportunities.

Comfort plan's zero-deductible model attracts cost-conscious employers and employees.

Virtual healthcare services align with rising demand, boosting member engagement.

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