Reinsurance Administrator

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🔥 3 minutes ago

🐻 Alaska, California, +2 more states – Remote

🐻 Alaska – Remote 🏄 California – Remote 🌺 Hawaii – Remote 🗽 New York – Remote

💵 $18 - $33 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🖥️ Administration

🚫👨‍🎓 No degree required

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Luminare Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

⚕️ Healthcare Insurance

Healthcare Insurance

Luminare Health is a leading provider of self-funded health plan administration services with over 50 years of industry experience. The company specializes in offering flexible and innovative solutions for hospitals, health systems, and direct-to-employer initiatives, focusing on administration, cost management, and digital reporting tools. Luminare Health is dedicated to being a reliable partner in managing healthcare costs and supporting strategic growth for its clients. The company emphasizes a member-centered approach to healthcare while delivering significant savings through expert claim analysis and management of high-cost claims.

📋 Description

• Responsible for accurate and timely filing of excess risk medical claims • Work collaboratively with excess risk companies to answer questions and resolve problems • Handle initial appeals for reinsurance • Coordinate all reporting that is supplied by the excess risk companies • Identify and prepare stop loss claims submissions to obtain client reimbursement • Communicate with Client Management, Claims, Finance and other impacted departments • Identify and notify stop loss carriers and clients of claimants that have reached 50% of the specific deductible amount • Review and process all returned checks resulting from stop loss reimbursements • Investigate carrier reimbursement denials and prepare/submit rebuttal or notification of explanation to the client • Prepare and distribute to Medical Claims Analysts and department Managers notifications of potential specific claimants requiring all claims to be processed by month-end

🎯 Requirements

• High School Diploma or GED equivalent • 1 – 2 years of medical claims experience • Hands-on experience with stop loss (excess risk) claims processing and submissions • Proficient experience with MS Word, Excel and Outlook • Previous knowledge of employee benefits, third party benefit administration or reinsurance • Self-directed individual that works well with minimal supervision • Flexible; open to change and finding better ways to operate efficiently • Excellent interpersonal and communication skills with all levels of an organization • Ability to effectively present information and respond to questions • Strong time management skills • Demonstrated problem-solving and claims investigation skills

🏖️ Benefits

• Health and wellness benefits • 401(k) savings plan • Pension plan • Paid time off • Paid parental leave • Disability insurance • Supplemental life insurance • Employee assistance program • Paid holidays • Tuition reimbursement