Reinsurance Analyst

Position Overview

Western Growers Health, part of the Western Growers Family of Companies, offers employer‐sponsored health benefit plans to support the agriculture industry. Our mission is to deliver value through robust health plans and excellent customer service. Reporting to the Manager of Claims, you will support claims processing for reinsurance carriers to obtain reimbursement for excess loss medical claims. This is a remote position offering flexibility anywhere in the U.S.

Key Responsibilities

• Support reinsurance claim processing by reviewing supporting documentation and ensuring accuracy.
• Gather, organize, and submit excess loss (stop loss) claims to various reinsurance carriers following designated guidelines.
• Prepare and send monthly as well as ad hoc reports for brokers, carriers, and clients.
• Monitor compliance with MEWA, ERISA, and California Department of Insurance standards to ensure timely reimbursement.
• Analyze claims data to identify high-dollar claims and audit carrier responses for accuracy.

Required Qualifications

• High school diploma or equivalent with 2 to 5 years of experience in medical/dental claims auditing, investigation or medical insurance account management.
• Proficient in ICD (ICD-9, ICD-10), CPT, and HCPCS II & III coding systems with experience in claims processing.
• Strong computer skills including familiarity with word processing, spreadsheets, and presentation software.
• Excellent organizational, time management, communication, critical thinking, and problem-solving skills.

Preferred Qualifications

• Experience with client-specific and aggregate reporting under reinsurance is a plus.

Benefits & Perks

• Compensation: $61,719.12 - $85,234.24 with a rich benefits package including profit-sharing.
• Remote position with the flexibility to reside anywhere in the U.S.
• Employer‐sponsored health benefits tailored for the agriculture industry.
• Opportunity to make a meaningful impact by supporting a diverse workforce with quality healthcare services.