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Medical Claims Analyst: Stephens Insurance, Life & Health


This is a Full-time position in Little Rock, AR posted March 12, 2021.

ESSENTIAL DUTIES AND RESPONSIBILITIESMedical Claims Analysis: Work with Stephens Insurance’s pharmacy, underwriting, data analytics, and client account teams to interpret medical claims and risk score data to identify key cost drivers within clients’ medical plan; evaluate the cost-effectiveness of medical treatments and services; and propose concrete benefit strategies to improve the overall health of employee populations.Medical Underwriting Support: Support Stephens Insurance’s underwriting and actuarial team in reviewing and interpreting medical claims and developing estimates for large, or “shock” claims.Stewardship & Client Engagement: Engage with self-funded clients at regular intervals to discuss trends in medical claims; identify specific opportunities for action around plan design and wellness initiatives; and educate clients about preventive medicine and what employers can do to effectively manage chronic diseases.Wellness Vendor Review: Participate in ongoing reviews of new vendor solutions and recommend clinically effective value-based benefits strategies and point solutions to increase the clinical effectiveness of benefits offered.Training & Education: Deliver trainings and webinars to non-clinical team members and clients related to our medical claims analytics strategy and solutions.Prospect Engagement: Meet with prospective clients to explain our approach to managing the risk of healthcare expenditures.EDUCATION AND EXPERIENCEProfessional degree (Ph.D., M.D., etc.), plus 2 years related experience and/or training, or equivalent combination of education and experience.REQUIRED CERTIFICATES, LICENSES, REGISTRATIONSMedical Degree or PhD in related field or a reasonable equivalent.SOFTWARE SKILLS REQUIREDAbility to navigate a claims analytics data warehouse.Advanced: SpreadsheetIntermediate: Contact Management, Presentation/PowerPoint, Word Processing/TypingBasic: 10-Key, Accounting, Alphanumeric Data Entry, Database

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