Christina Moser
Glen Burnie
Summary
Dynamic Stop Loss Manager with proven expertise at ClaimChoice in leading teams and enhancing reinsurance strategies. Skilled in complex problem-solving and meticulous reporting, I successfully managed end-to-end stop loss claims processing while fostering collaboration across departments. Recognized for my attention to detail and ability to drive compliance, I consistently deliver results that exceed expectations.
Overview
10
10
years of professional experience
Work History
Stop Loss Manager
ClaimChoice
Royal Oak, MI
12.2021 - Current
- Facilitated weekly team meetings to assess progress, share updates, and strategize future initiatives.
- Accomplished multiple tasks within established timeframes.
- Prepared detailed reports on reinsurance transactions, ensuring compliance with industry regulations and internal policies.
- Evaluated claims data to identify trends and recommend adjustments in reinsurance strategies.
- Managed the end-to-end processing of stop loss claims.
- Collaborate with the claims and account management teams to ensure accurate and timely claims processing and to provide strategic input on risk mitigation.
- Work with the finance team to ensure stop-loss reimbursement are accounted for and properly reconciled.
- Provide consultative support to clients on stop-loss policy options, claims filing process, and reimbursement expectations.
Stop Loss Team Leader
BeneSys
08.2015 - 11.2021
- Run and Review all year -end reporting for renewals and special reports.
- Run and Review month-end reporting for potential claimants for stop loss and client Request.
- Review and approve to open or close case management cases.
- Review and set up a suitable Transplant network for Clients that do not have a specific Transplant vendor.
- Take calls from providers, members, Claim staff, client representatives and off-site offices. Answers inquiries pertaining to specific cases as well as Industry standards.
- Track all activity, follow up as required, and send reports to Plan Managers, Claim Management team as necessary.
- Review SPD and SMM drafts, Network benefit summaries, Internal processing notes and BIB’s for accuracy/compliance.
- Maintain tracking of all clients with Stop Loss, while maintaining contracts for these clients Reinsurance Carrier.
Education
High School Diploma -
Kent Island High Scholl
Stevensville, MD05-2000
Skills
- Team leadership
- Complex Problem-solving
- Task delegation
- Schedule preparation
- Work prioritization
- Problem resolution
- Positive attitude
- Attention to detail
- Time management
- Decision-making
Timeline
Stop Loss Manager
ClaimChoice
12.2021 - Current
Stop Loss Team Leader
BeneSys
08.2015 - 11.2021
High School Diploma -
Kent Island High Scholl