Silver Spring, Maryland30+ days ago
Provide cost containment by managing an inventory of Stop Loss claims (involving large case management, trigger diagnosis or transplant network losses), securing additional discounts from providers (either directly or through a preferred vendor), negotiating prices for medical services and supplies, negotiating settlements, developing transplant networks, evaluating losses, consulting with claims examiners about appropriateness of charges and educating clients and stop loss team about cost-effective alternatives. Gather and analyze clinical information and medical records from all providers for cost containment and future cost determination by maintaining a close working relationship with plan administrators, vendors, third party payers, employers, re-insurers, and other social, psychological, and medical health care providers.