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Stop Loss Program Coordinator, Seattle, WA


Physicians Insurance A Mutual Company

Professional

Seattle, WA

October 31, 2018


Stop Loss Program Coordinator

Physicians Insurance A Mutual Company provides traditional, first-dollar medical professional liability insurance, medical stop loss, provider excess, and reinsurance coverage to more than 7,500 physicians, practices, corporations, and hospitals in Washington, Idaho, Oregon, Alaska, and Wyoming. Through its subsidiaries, the company also provides alternative risk financing vehicles and captive management with corresponding risk-management consulting, continuing medical education, and claims administration services. Founded in 1981, Physicians Insurance has grown to be the largest locally-based insurer of physicians in its region, and is rated A- (Excellent) by A.M. Best Company. Physicians Insurance maintains corporate headquarters in Seattle, with regional and subsidiary offices in Spokane, WA, Portland, OR, Milton, VT, and Orlando, FL. We are proud to have a long history of excellent operating results and a commitment to our policyholders, our employees, and the communities we serve. We currently have an exciting opportunity for a Stop Loss Program Coordinator.

The Stop Loss Program Coordinator is primarily responsible for supporting the Stop-Loss department with all aspects of business, including new and renewal business activities, claims processing and customer support.

Key Functions:

Responsibilities include but are not limited to the following:

  • Receives and processes stop loss claim filings and notices
  • Prepares Explanation of Benefit cover letters and other correspondence as needed
  • Reviews and monitors claims activity, ensuring all claims filed timely to meet policy turn-around time
  • Identifies large claim notifications and filings for potential case management support as well as administering large claims in adherence with reinsurer requirements
  • Communicates with brokers, TPA’s and/or account contacts to obtain documentation for day to day business activities
  • Responds timely and accurately to customer inquiries
  • Organizes and coordinates RFP information received for new business proposals for our Alternative Markets
  • Performs other duties and responsibilities as required

Requirements / Qualifications:

  • Associate or Bachelor’s degree preferred, or equivalent work experience
  • 2+ years of experience in Stop Loss desired, or complex medical claims processing
  • Working knowledge of medical terminology, including CPT and HCPC codes. Familiarity with Medicare RBRVS fee schedule, Medicare DRG Pricer schedule, Medicaid APDRG schedule and/or UB Revenue Codes is strongly desired.
  • Effective organizational and prioritization skills with a demonstrated ability to multi-task and manage workload to meet deadlines.
  • Strong attention to detail, ability to follow detailed instructions and work independently
  • Demonstrated commitment to customer service and quality, and working in a collaborative team environment
  • Excellent interpersonal, verbal, and written communication skills
  • Demonstrated technical ability to work with Microsoft Office software applications (Word, Excel, PowerPoint, Outlook)
  • Ability to lift or carry up to 40 pounds.

At Physicians Insurance, you’ll find an exceptional work environment, an impressive benefits package, and the opportunity to work for an industry leader whose programs have a positive impact on the practice of medicine and patient safety.

To apply for this position, send your resume to recruiter@phyins.com.


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