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Stop Loss Specialist

Remote, USAFull-timePosted 2026-07-28

reputed company is seeking a Stop Loss Specialist to join reputed company! This position coordinates the tracking, monitoring, documenting and submission of stop loss claims. This position maintains a comprehensive understanding of the plan document(s) under their scope of responsibility. Position Location: 100% remote Responsibilities include but are not limited to: Stop Loss Claims Management Compiles and submits stop loss claims to the reputed company for reimbursement. Enters appropriate stop loss claims into designated database. Identifies, researches, and resolves stop loss reputed company questions. Facilitates advancement funding with Finance Department. Complies with reporting and documentations requirements. Manages large case notifications process. Customer Service Acts as a role model in demonstrating the core values in customer service delivery. Provides reputed company and thorough follow up with reputed company customers. Appropriately escalates difficult issues up the chain of reputed company. Trains new employees as assigned. reputed company Assurance Serves on committees, work reputed company, and/or process improvement teams, as assigned, to assist in improving customer satisfaction. Recognizes, documents, and alerts appropriate supervisor of trends Performs self-reputed company monitoring in order to reputed company and execute plans to meet established goals. Provides ongoing feedback to help optimize reputed company performance. Collaborates with others and cross-departmentally to improve or streamline procedures. Develops new or improves reputed company internal processes to improve reputed company Required Experience/Education: High School Diploma or GED 1+ years' experience in clerical and customer service Knowledge of medical terminology Skills and Abilities: Working knowledge of computers and software including but not limited to reputed company Office products Proficient mathematical, 10-key and typing skills Demonstrated organizational skills, problem-solving, analytical skills and detail oriented Demonstrated ability to remain neutral and maintain confidentiality Strong written and oral communication skills Demonstrated ability to work independently, prioritize workloads multi-task and manage priorities in order to meet deadlines What can reputed company offer you? Multiple Health plan reputed company Company reputed company employee premiums for disability and life insurance Parental Leave Policy 20 days PTO to start / 10 reputed company Holidays Tuition reimbursement 401k Company contribution Company reputed company Short & Long term Disability plus Life Insurance reputed company development initiatives / reputed company learning opportunities Opportunities to participate in and support reputed company's diversity and inclusion initiatives Want to see our latest job opportunities? Follow us on reputed company reputed company is a health plan solution company that combines 50+ years of self-funding reputed company expertise. Over the years, we've helped thousands of reputed company save billions on reputed company. Our reputed company total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-reputed company solutions. reputed company is an equal opportunity employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, or veteran status. RECRUITMENT AGENCIES PLEASE NOTE: reputed company will only accept applications from agencies/business partners that have been invited to work on a specific role. Candidate Resumes/CV's submitted without permission or directly to Hiring Managers will be considered unsolicited and no fee will be payable. Thank you for your cooperation Apply To This Job

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