Top 1868 Medical stop loss Jobs

Stop Loss Claims Coordinator
Sigmatico, LLC —Remote
- $50,000 - $60,000 a year
- Full-time
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
10d
Medical Stop Loss Claims Auditor
Evolution Risk Partners, LLC —Remote
- $75,000 - $85,000 a year
- Remote
- Customer service
- Writing skills
- Mid-level
- Health savings account
- Paid holidays
Quick Apply
Senior Underwriter OR AVP - Medical Stop Loss (Captives)
Skyward Specialty Insurance —Remote
- $100,000 - $170,000 a year
- Full-time
- Remote
- Writing skills
- Mid-level
- Analysis skills
- Employee stock purchase plan
- Paid holidays
Senior Underwriter or AVP, Medical Stop Loss (Core)
Skyward Specialty Insurance —Remote
- $100,000 - $170,000 a year
- Full-time
- Remote
- Writing skills
- Mid-level
- Analysis skills
- Employee stock purchase plan
- Paid holidays
Clinical Risk Manager, C&F Stop Loss
Crum & Forster —Eatontown, NJ
- $67,900 - $127,600 a year
- Remote
- Nursing
- 6 years
- Microsoft Outlook
- Employee stock purchase plan
- Health insurance
Stop Loss Administrative Support Assistant
Foundation Risk Partners —Avon, CT
- Remote
- Microsoft Outlook
- Mid-level
- Administrative experience
- Paid holidays
- Disability insurance
Quick Apply
Premium Operations Associate, Medical Stop Loss - Hybrid
Crum & Forster —Scottsdale, AZ
- $38,300 - $56,200 a year
- Research
- Mid-level
- Microsoft Office
- Employee stock purchase plan
- Health insurance
Claims Support Specialist, Medical Stop Loss - Hybrid
Crum & Forster —Scottsdale, AZ
- $34,800 - $51,000 a year
- Mid-level
- Office
- High school diploma or GED
- Employee stock purchase plan
- Health insurance
Stop Loss Analyst
The Hilb Group —Canton, MA
- $72,000 a year
- Full-time
- Hybrid work
- Microsoft Excel
- Mid-level
- Databases
- Health savings account
- Disability insurance
Amwins A&H- Claims Manager, Stop Loss
Amwins —Seattle, WA
- $140,000 - $155,000 a year
- Remote
- Bachelor's degree
- Mentoring
- Organizational skills
- Health insurance
Quick Apply
Medical Stop Loss Pricing Actuary
WTW —Chicago, IL
- Full-time
- SQL
- Analysis skills
- Presentation skills
- Paid jury duty
- Health savings account
Vice President, Member Experience
Everlong Captive —Ponte Vedra, FL
- $120,000 - $140,000 a year
- Full-time
- 3 years
- Bachelor's degree
- Travel
- Health savings account
- Health insurance
Quick Apply
Safety Specialist
Treeways —Pittsburgh, PA
- Full-time
- Microsoft Word
- Spanish
- Clean driving record
- Paid holidays
- Health insurance
Quick Apply
Production Manager
American Outdoor Products —Boulder, CO
- $80,000 - $100,000 a year
- Weekends as needed
- Bilingual
- Background check
- 5 years
- Health savings account
- Paid holidays
Quick Apply
14d
Trade Sales Consultant
Pella of WYIDAHO —Idaho Falls, ID
- From $50,000 a year
- Full-time
- Hybrid work
- Background check
- Clean driving record
- Construction site
- Profit sharing
- Health insurance
Quick Apply
Respiratory Therapist RRT
HCA Florida Capital Hospital —Tallahassee, FL
- Full-time
- Mid-level
- Critical & Intensive Care
- Employee stock purchase plan
- Disability insurance
Quick Apply
Medical Stop Loss Underwriter
Strategic Staffing Solutions —Minneapolis, MN
- $50 - $52 an hour
- Contract
- Hybrid work
- Mid-level
- Analysis skills
- Bachelor's degree
Quick Apply
2d
Director, Utilization Management & Operational Integrity
Medical Mutual of Ohio —Cleveland, OH
- Hybrid work
- Nursing
- Microsoft Excel
- Microsoft Outlook
- Health savings account
- Disability insurance
Security Officer I, Per Diem
University of New England —Portland, ME
- $21 an hour
- Part-time
- CPR Certification
- Military
- High school diploma or GED
- COVID-19 protective measures
Certified Police Officer
White Haven Police Department —White Haven, PA
- From $24 an hour
- Part-time
- Writing skills
- Mid-level
- Conflict management
- Paid time off
Quick Apply
3d

I want to receive the latest job alert for medical stop loss

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Stop Loss Claims Coordinator

Sigmatico, LLC
Remote

Quick Apply

Job Details

Full-time
$50,000 - $60,000 a year
10 days ago

Benefits

Health insurance
Dental insurance
401(k)
Work from home
Life insurance

Qualifications

Financial data reconciliation
Spreadsheets
Filing
Payment reconciliation for medical billing
ICD-10
Attention to detail
Coordinating with insurance clients
Vendor communication
Management reporting
Medical claims submission
Process management
Excel data analysis

Full Job Description

Position Summary

The Stop Loss Claims Coordinator is the operational engine behind successful stop loss reimbursement. In this role, you will identify potential claims, gather and validate documentation from TPAs, submit complete claim packets to carriers, and relentlessly follow each claim through adjudication until payment is secured. You will be the central point of communication between TPAs, carriers, brokers, and internal teams — ensuring accuracy, speed, and transparency throughout the entire process.

Key Responsibilities

Claim Identification & Filing

Proactively monitor and retrieve claims data from various TPA portals to identify claimants approaching or exceeding specific deductibles.
Gather medical records, proof of payment, eligibility files, and other required documentation.
Prepare and submit complete claim packets to carriers, tailored to each carrier’s contractual requirements.
Ensure all filings meet deadlines and comply with policy terms.

Workflow Management & Advocacy

Maintain consistent, professional follow‑up with carriers to push claims toward adjudication.
Work directly with TPAs to obtain missing information or clarify discrepancies.
Track claim status daily and communicate updates to brokers and internal stakeholders.
Verify reimbursement amounts and ensure timely communication once payments are issued.

Tracking & Reporting

Maintain a real‑time master log of all filed, pending, and paid claims.
Reconcile reimbursements against expected amounts to ensure accuracy.
Provide visibility into the agency’s stop loss portfolio through organized reporting.

Required Skills & Qualifications

Stop Loss Expertise: Understanding of the relationships between TPAs, General Agencies, and carriers.
Claims & Medical Data Fluency: Ability to interpret claims files, eligibility reports, and CPT/ICD‑10 codes.
Persistent Communication: Comfortable being the “squeaky wheel” with carriers while maintaining professionalism.
Excel Proficiency: Ability to track complex datasets and calculate potential claim values.
Organizational Strength: Capable of managing a high volume of active claims across multiple groups and carriers.
Attention to Detail: Ensures accuracy in documentation, submissions, and financial reconciliation.

Preferred Experience

Prior experience in stop loss, medical claims, TPA operations, or carrier claims processing.
Familiarity with common TPA portals and carrier submission requirements.
Experience in a General Agency or stop loss brokerage environment.

Pay: $50,000.00 - $60,000.00 per year

Benefits:

401(k)
Dental insurance
Health insurance
Life insurance
Work from home

Work Location: Remote

Quick Apply

Refine Your Search

medical stop loss jobs

Stop Loss Claims Coordinator

Medical Stop Loss Claims Auditor

Senior Underwriter OR AVP - Medical Stop Loss (Captives)

Senior Underwriter or AVP, Medical Stop Loss (Core)

Clinical Risk Manager, C&F Stop Loss

Stop Loss Administrative Support Assistant

Premium Operations Associate, Medical Stop Loss - Hybrid

Claims Support Specialist, Medical Stop Loss - Hybrid

Stop Loss Analyst

Amwins A&H- Claims Manager, Stop Loss

Medical Stop Loss Pricing Actuary

Vice President, Member Experience

Safety Specialist

Production Manager

Trade Sales Consultant

Respiratory Therapist RRT

Medical Stop Loss Underwriter

Director, Utilization Management & Operational Integrity

Security Officer I, Per Diem

Certified Police Officer

I want to receive the latest job alert for medical stop loss

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected