Claims Specialist - Accident and Health (Medical Stop Loss)

Primary Details

Time Type: Full time
Worker Type: Employee
Claims Specialist - Accident and Health (Medical Stop Loss)
Location: USA – MA, Marblehead; Atlanta, GA
Salary Range: $76,000-125,500K

Opportunity

The purpose of this role is to provide exceptional claims service to our Accident & Health Medical Stop Loss customers by managing complex medical stop loss claims effectively.

Responsibilities

• Support the implementation of the Claims strategy to enable the delivery of overall business targets.
• Maintain current knowledge of insurance guidelines, policy changes, and modifications.
• Maintain good client relationships with insured individuals, agents, service providers, and the general public.
• Provide claim management for various types of insurance claims.
• Identify and implement strategies to minimise Claims Costs and Leakage.
• Respond to client requests following service standards.
• Aid in the negotiation of claims settlements.
• Participate in relevant meetings to share and develop strategy, knowledge, and best practices.
• Identify and resolve issues or anomalies non-compliant with policies and procedures.
• Aid in the daily review of reports and ad hoc reporting.
• Mentor and coach junior staff as required.

Qualifications

• Necessary Qualifications include: Tertiary Degree or equivalent combination of education and work experience.
• Relevant insurance qualifications.

Compensation Package

The salary range for this role is provided above. This is the national range for location(s) listed. The salary offer will be decided based on the role's complexity, its location, and the candidate’s professional background, including their education and experience. Beyond the base salary, regular full-time and part-time employees will also be eligible for QBE’s annual discretionary bonus plan based on business and individual performance.

Benefits

We offer a range of benefits to help provide holistic support for your work life, whatever your circumstances. As a QBE employee you will have access to:

• Hybrid Working – a mix of working from home and in the office
• 22 weeks of paid leave for family growth, with 12 weeks available to all parents on a gender-equal basis
• Competitive 401(k) program with company match up to 8%
• Well-being program including holistic wellbeing coaching, gym membership, confidential counselling, financial and legal advice
• Tuition Reimbursement for professional certifications, and continuing education
• Employee Network and Community – QBE actively supports six Employee Networks, and many ways to give back to your community

Why QBE?

To successfully perform this job, the individual must be able to perform each essential job responsibility satisfactorily. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential job responsibilities.

Supplementary Information

Global Disclaimer: The duties listed in this job description do not limit the assignment of work. They are not to be construed as a complete list of the duties normally to be performed in the position or those occasionally assigned outside an employee’s normal duties.

US Only Disclaimer

To successfully perform this job, the individual must be able to perform each essential job responsibility satisfactorily. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential job responsibilities.

Equal Employment Opportunity

QBE provides equal employment opportunities to applicants and employees without regard to race; color; gender; gender identity; sexual orientation; religious practices and observances; national origin; pregnancy, childbirth, or related medical conditions; protected veteran status; or disability or any other legally protected status.