Top 1566 Medical stop loss Jobs

Medical Review Nurse- Stop Loss
Roundstone —Rocky River, OH
- $80,000 - $85,000 a year
- Full-time
- Hybrid work
- Background check
- Nursing
- Mid-level
- Health savings account
- Disability insurance
Quick Apply
Medical Stop Loss/Insurance
Ultimate Staffing Services —East Hartford, CT
- $24 - $25 an hour
- Full-time
- Mid-level
- Analysis skills
- Fair chance
Quick Apply
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
Medical Stop Loss Claims Group Insurance
Prudential —Newark, NJ
- $106,000 - $174,900 a year
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Bachelor's degree
- Employee stock purchase plan
- Disability insurance
4d
Claims Specialist - Accident and Health (Medical Stop Loss)
QBE —Marblehead, MA
- Full-time
- Remote
- Mid-level
- US work authorization
- Experience equivalent to degree accepted
- Tuition reimbursement
- 401(k) matching
Senior Claims Specialist - Accident & Health (Medical Stop Loss)
QBE —Marblehead, MA
- Full-time
- Remote
- Mid-level
- US work authorization
- Experience equivalent to degree accepted
- Tuition reimbursement
- 401(k) matching
Reinsurance Administrator (Stop Loss) - LH
Luminare Health —Remote
- $18.07 - $33.92 an hour
- Full-time
- Remote
- Microsoft Word
- Microsoft Outlook
- Mid-level
- Paid parental leave
- Paid holidays
11d
Senior Underwriter - Medical Stop Loss
Jencap —Danvers, MA
- Remote
- 5 years
- Finance
- Bachelor's degree
- 401(k)
- Tuition reimbursement
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Medical Stop Loss Underwriting Consultant
HM Insurance Group —Pennsylvania
- $94,200 - $151,000 a year
- Full-time
- Remote
- 6 years
- Computer Science
- Office
11d
Stop Loss Revenue Associate
Allied Benefit Systems —Chicago, IL
- $20 - $23 an hour
- Full-time
- Remote
- Microsoft Excel
- Customer service
- Administrative experience
- Disability insurance
- Health insurance
10d
Regional Sales Director, Medical Stop Loss
Prudential —Chicago, IL
- Full-time
- Remote
- Up to 50% travel
- 8 years
- Continuous improvement
- Employee stock purchase plan
- Disability insurance
Revenue Analyst-Healthcare Stop Loss (Remote)
Allied Benefit Systems —Chicago, IL
- $55,000 - $65,000 a year
- Full-time
- Remote
- Microsoft Excel
- Microsoft Access
- Mid-level
- Disability insurance
- Health insurance
14d
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
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
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 Claims Specialist I-Specific
Allied Benefit Systems —Chicago, IL
- $23 - $24 an hour
- Full-time
- Remote
- High school diploma or GED
- Analysis skills
- Accounting
- Disability insurance
- Health insurance
Stop Loss Claims Analyst
Kismet Risk Management Associates, LLC —Remote
- From $40,000 a year
- Full-time
- Mid-level
- Communication skills
- Health insurance
- Dental insurance
Quick Apply
12d
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
Stop Loss Claims Specialist II-Specific
Allied Benefit Systems —Chicago, IL
- $24 - $26 an hour
- Full-time
- Remote
- Mid-level
- Finance
- High school diploma or GED
- Disability insurance
- Health insurance
Medical Stop Loss Underwriting Practice Lead, Accident & Health
National Union Fire Insurance Company of Pittsburgh, Pa. —Chicago, IL
- $118,000 - $178,000 a year
- Email
- 7 years
- Customer service
- Office
- Health insurance
Quick Apply

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Medical Review Nurse- Stop Loss

Roundstone -
Rocky River, OH

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Job Details

Full-time
$80,000 - $85,000 a year

Benefits

Health savings account
Disability insurance
Health insurance
On-site gym
Dental insurance
401(k)
Flexible spending account
Tuition reimbursement
Paid time off
Parental leave
Employee assistance program
Vision insurance
401(k) matching
Professional development assistance
Life insurance
Referral program

Qualifications

Nursing
Critical & intensive care
RN experience
Insurance medical billing
Attention to detail
Medical treatment knowledge
Medical billing
Bachelor's degree in nursing
Oncology
Clinical documentation standards
Medical terminology

Full Job Description

Medical Review RN – Stop Loss

Founded in 2003, Roundstone is not your typical insurance company. We’re on a mission to help employers save on healthcare benefits so they can put those savings towards bettering their businesses and taking care of their employees.

Role Description

As a Medical Review Nurse in Roundstone’s medical expense stop loss program, you will work with the claims staff to identify potentially large claims early in the process and use your expertise to manage the medical services. You’ll serve as a subject matter expert on newly approved and emerging treatments and help spot trends in patient care. Third party administrators and vendors will work closely with you on a regular basis. This position also works closely with the stop loss underwriters when preparing renewal and potential quotes for cost predictions and cost containment options. Review of amendments and informing underwriters if this addition to the plan will have a significant financial impact on the group. This is a great opportunity for someone with a nursing background to move into the insurance field.

Key Duties & Responsibilities:

Ability to recognize potentially catastrophic diagnoses.
Strong communicator, particularly regarding discussing and concisely summarizing medical conditions with non-medical professionals.
Recognizes salient data to leverage in individual cases and trend for business stakeholders.
Capable of identifying and completing tasks with minimal direct instruction. Tracks results and communicates status with stakeholders.
Ability to multitask, prioritize, and find creative problem resolutions.
Open collaborator with the ability to influence and lead indirectly.

Skills and Qualifications:

Bachelor's degree in nursing
Oncology and Critical Care experience a plus
Exposure to medical billing, coding, and negotiation is a plus, but not required
Minimum of 2 years nursing experience
Experience reviewing/auditing medical records related to patient treatment, diagnosis, and provider billing to identify any medical and coding discrepancies.
Critical/analytical skills with a strong attention to detail
Strong work ethic

Better Benefits:

We’re leaders in our industry, so naturally, we look out for our employees’ best interests with a robust benefits package. Roundstone employees are eligible for:

Medical, dental and vision benefits
Annual bonus
Dependent care 100% match up to max allowable
Parental leave
Parental leave
PTO beginning on Day 1
Tuition reimbursement
Healthy work/life balance
Hybrid office schedule
401(k) plan with company match
Employee Assistance Program
On-site gym with personal trainer access
Life insurance and short term disability insurance

More About Roundstone

Headquartered in Rocky River, Ohio, Roundstone is proud to be a Northeast Ohio Top Workplace as recognized by The Plain Dealer and cleveland.com, based on anonymous employee feedback. We foster a supportive, values-driven culture where employees feel engaged, valued, and celebrated. Roundstone has also been named an Inc. 5000 award recipient for eight consecutive years, reflecting our continued growth and success.

Our Core Values

Live well: Be healthier and bring positive energy to all you do.
Work smarter: Get things done, better.
Own it: Accountability is your middle name. Be on time, do what you say, and finish what you start.
Be intellectually curious: Always be learning. See opportunity everywhere and have a drive to know.

Culture and fit are integral to success and in an effort to achieve a better match both from a candidate's perspective and our organization, please take a minute, click on the link and take the really brief survey:

https://go.cultureindex.com/p/vdNOUHg4OcQTU

Don't meet every single requirement? Studies have shown that women and people of color are less likely to apply to jobs unless they meet every single qualification. At Roundstone Insurance we are dedicated to building a diverse, inclusive, and authentic workplace, so if you're excited about this role but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyways. You may be just the right candidate for this or other roles.

Job Type: Full-time

Pay: $80,000.00 - $85,000.00 per year

Benefits:

401(k)
401(k) matching
Dental insurance
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid time off
Parental leave
Professional development assistance
Referral program
Tuition reimbursement
Vision insurance

Work Location: Hybrid remote in Rocky River, OH 44116

Quick Apply

Refine Your Search

medical stop loss jobs

Medical Review Nurse- Stop Loss

Medical Stop Loss/Insurance

Medical Stop Loss Claims Auditor

Medical Stop Loss Claims Group Insurance

Claims Specialist - Accident and Health (Medical Stop Loss)

Senior Claims Specialist - Accident & Health (Medical Stop Loss)

Reinsurance Administrator (Stop Loss) - LH

Senior Underwriter - Medical Stop Loss

Medical Stop Loss Underwriting Consultant

Stop Loss Revenue Associate

Regional Sales Director, Medical Stop Loss

Revenue Analyst-Healthcare Stop Loss (Remote)

Senior Underwriter or AVP, Medical Stop Loss (Core)

Senior Underwriter OR AVP - Medical Stop Loss (Captives)

Claims Support Specialist, Medical Stop Loss - Hybrid

Stop Loss Claims Specialist I-Specific

Stop Loss Claims Analyst

Premium Operations Associate, Medical Stop Loss - Hybrid

Stop Loss Claims Specialist II-Specific

Medical Stop Loss Underwriting Practice Lead, Accident & Health

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