- Highmark Health (Albany, NY)
- …**Job Description :** **JOB SUMMARY** This job reviews, evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with ... big impact for those we serve. **ESSENTIAL RESPONSIBILITIES** + Processes daily incoming Stop Loss claims including initial entry claims or subsequent claims as… more
- WTW (New York, NY)
- …on funding strategies, underwriting pools, credibility methods, pooling point analysis, and stop - loss solutions to optimize risk management. + Carrier and Market ... + Deep understanding of employer health risk management strategies, including stop - loss , credibility, and rating mechanics. + Experience advising small… more
- Highmark Health (Albany, NY)
- …recommendations or proposals for action. Interns will acquire practical business experience in stop loss underwriting while working with Stop Loss ... underwriting experts. **REQUIRED QUALIFICATIONS** + Full or part-time enrollment in an accredited college or university baccalaureate program. **PREFERRED ANTICIPATED GRADUATION DATES** + Spring 2026 + Summer 2026 + Winter 2026 + Spring 2027 **ESSENTIAL JOB… more
- HUB International (Melville, NY)
- …self funded and large fully insured clients, as appropriate + Secure stop - loss coverage for self-insured clients, as appropriate **Knowledge/Skills & Abilities ... array of insurance, retirement, and wealth management products and services. But we don't stop there - we also invest deeply in our people. Here, your career is… more
- CVS Health (Albany, NY)
- …industry and account management experience. - Self-funded insurance experience. - Stop - loss knowledge. - Proficiency with desktop software applications such ... as Outlook, Word, PowerPoint, Teams, and Salesforce. - Must reside in Eastern Time (ET). - Travel required 10-25%. **Preferred Qualifications** - Strong critical thinking, time management, and organizational skills. - Resides in southeastern United States. -… more
- Northwell Health (New York, NY)
- …TPA account management for renewal distribution and negotiations with the plan vendors ( Stop loss , PBM, etc *Additional Salary Detail The salary range and/or ... hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base… more
- Highmark Health (Albany, NY)
- …someone who has experience with health insurance and has worked with TPA, Stop loss , and self-funded clients.** **ESSENTIAL RESPONSIBILITIES** + Review new ... products, services, capabilities, and technologies with the client in order to sell assigned product lines, renewals and add-on sales to ensure retention, profitability and growth of existing business. + Manage relationships at senior levels with clients,… more
- University of Rochester (Rochester, NY)
- …to, but not limited to, enrollment, premiums, claims, payments, prescription rebates, and stop - loss insurance to ensure proper booking of revenues and expenses. ... + Prepares annual footnote for University financial statements and performs other year-end close activities. **Financial Compliance & Administration** + Is the leading subject matter expert on all federal and state regulations associated with financial… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …HMO Statements. + Leads preparation and submission of Regulation 146 and Direct Pay Stop Loss reports to the NYS Insurance Department. + Oversees the submission ... and quality of NYS and CMS regulatory encounter submissions and supports all required audits, internal and external to ensure accuracy. Leads preparation reporting, valuation, and forecasting of risk adjustment scores and revenue to support partners internal… more
- Amazon (New York, NY)
- …funding and scoring performance compared to plan expectations. -Complete the evaluation of stop - loss coverage and manage third party vendors -Analyze and develop ... new to market assessments and modeling which includes future Medicare geographic expansion and enhancements / changes to other market segments (Commercial potentially) Basic Qualifications - 6+ years of data scientist experience - Associate of the Society of… more