Gen Re
Medicare Supplement Large Loss, Complex Claims Reinsurance Specialist
Stamford, CT, US
Sponsorship not specifiedDetected 71 days ago
Mentoring
About the role
- This role ensures accurate claim determinations, protects organizational financial integrity, and strengthens operational excellence through training and process improvement.
- Large‑Loss, Complex Claims Adjudication Review, investigate, and adjudicate high‑dollar Medicare Supplement claims with accuracy, timeliness, and full regulatory compliance.
- Analyze medical records, provider documentation, and policy provisions to determine eligibility and benefit levels.
Responsibilities
- Reinsurance and Audit Functions Perform detailed reinsurance due diligence efforts audits to validate claim accuracy, recover eligible reimbursements, and ensure adherence to treaty requirements.
- Prepare audit reports, document findings, and recommend corrective actions to improve financial outcomes.
- Risk Management and Training Develop and deliver training programs for claims staff on risk identification, mitigation strategies, and best‑practice adjudication.
Benefits
- Collaborate with internal teams, medical consultants, and external constituents to resolve complex claim issues.
This listing is sourced directly from Gen Re's careers page and normalized into a canonical job model.