Stop Loss Coordinator Job at Robert Half (Feasterville-Trevose)

Stop Loss Specialist

We're seeking a detail-oriented professional who can support the coordination an...

Location

United States , Covington

Salary:

21.00 - 23.00 USD / Hour

Personify Health

Expiration Date

Until further notice

Requirements

High school diploma or general education degree (GED) required
Minimum 3 years related experience and/or training, or equivalent combination of education and experience
Completion of training programs through HIPAA, ICA and/or LOMA, and continuing education courses relative to Stop Loss preferred
Knowledge of medical terminology, CPT, HCPCS, and ICD-10 codes
Computer literacy with proficiency in Windows and Microsoft Office environment (Word, Excel, Outlook)
Knowledge of insurance database systems preferred
Experience with EDOCS platform or similar documentation management systems
Detail-oriented, analytical, financially minded approach to Stop Loss coordination
Ability to read, analyze, and interpret common financial reports and legal documents
Capability to work with mathematical concepts such as probability and statistical inference

Job Responsibility

Prepare Stop Loss submissions: Analyze Stop Loss claims and applicable documents to determine filing eligibility under Excess Loss Policy while processing all submissions within established timeframes
Coordinate funding requests: Manage Advanced Funding Requests with clients and Stop Loss carriers while maintaining comprehensive database of all specific reimbursement requests
Manage documentation systems: Create initial Specific File for each claimant and file all submissions in EDOCS platform while coordinating release of Over Specific, System Hold claims
Serve as liaison: Act as connection point between PBMs and internal clients for Stop Loss claimants while maintaining professional communication with all stakeholders
Monitor reimbursements: Track all reinsurance requests to ensure receipt of reimbursement while generating weekly outstanding reimbursement reports and following up with carriers
Support plan year activities: Assist with Plan Year End Closeouts while keeping immediate supervisor apprised of open or disputed items requiring attention
Maintain workflow excellence: Contribute to daily workflow with regular, punctual attendance while performing related or assigned duties as required

What we offer

Competitive base salary and benefits effective day one
Comprehensive medical and dental through our own health solutions
Paid Time Off
Mental health support, retirement planning, and financial protection
Professional development with clear career progression and learning budgets
Mission-driven culture where diverse perspectives drive real impact on people's health

Fulltime

Health Claims Stop Loss Specialist

We're seeking a detail-oriented professional who can support the coordination an...

Location

United States

Salary:

19.00 - 22.00 USD / Hour

Personify Health

Expiration Date

Until further notice

Requirements

High school diploma or general education degree (GED) required
Minimum 3 years related experience and/or training, or equivalent combination of education and experience
Completion of training programs through HIPAA, ICA and/or LOMA, and continuing education courses relative to Stop Loss preferred
Knowledge of medical terminology, CPT, HCPCS, and ICD-10 codes
Computer literacy with proficiency in Windows and Microsoft Office environment (Word, Excel, Outlook)
Knowledge of insurance database systems preferred
Experience with EDOCS platform or similar documentation management systems
Detail-oriented, analytical, financially minded approach to Stop Loss coordination
Ability to read, analyze, and interpret common financial reports and legal documents
Capability to work with mathematical concepts such as probability and statistical inference

Job Responsibility

Prepare Stop Loss submissions: Analyze Stop Loss claims and applicable documents to determine filing eligibility under Excess Loss Policy while processing all submissions within established timeframes
Coordinate funding requests: Manage Advanced Funding Requests with clients and Stop Loss carriers while maintaining comprehensive database of all specific reimbursement requests
Manage documentation systems: Create initial Specific File for each claimant and file all submissions in EDOCS platform while coordinating release of Over Specific, System Hold claims
Serve as liaison: Act as connection point between PBMs and internal clients for Stop Loss claimants while maintaining professional communication with all stakeholders
Monitor reimbursements: Track all reinsurance requests to ensure receipt of reimbursement while generating weekly outstanding reimbursement reports and following up with carriers
Support plan year activities: Assist with Plan Year End Closeouts while keeping immediate supervisor apprised of open or disputed items requiring attention
Maintain workflow excellence: Contribute to daily workflow with regular, punctual attendance while performing related or assigned duties as required

What we offer

Comprehensive medical and dental coverage through our own health solutions
Mental health support and wellness programs designed by experts who get it
Flexible work arrangements that fit your life
Retirement planning support to help you build real wealth for the future
Basic Life and AD&D Insurance plus Short-Term and Long-Term Disability protection
Employee savings programs and voluntary benefits like Critical Illness and Hospital Indemnity coverage
Professional development opportunities and clear career progression paths
Mentorship from industry leaders who want to see you succeed
Learning budget to invest in skills that matter to your future
Competitive base salary that rewards your success

Fulltime

Stop Loss Auditor

A Connecticut based Medical Insurance company is seeking an experienced Stop Los...

Location

United States

Salary:

65000.00 - 75000.00 USD / Year

Daley and Associates

Expiration Date

Until further notice

Requirements

3+ years of medical stop loss insurance experience (required)
Experience auditing stop loss or first-dollar medical claims
Strong knowledge of: Plan Documents and Stop Loss policies, Reinsurance contracts, Medical terminology and coding (ICD-10, HCPCS, CPT-4)
Ability to work independently in a remote environment while collaborating with a team

Job Responsibility

Audit medical stop loss claims for assigned clients
Review and approve Plan Documents to ensure compliance
Evaluate reimbursement requests and determine claim validity
Verify claims are paid according to Plan Documents and Stop Loss policies
Confirm participant and dependent eligibility
Review high-cost claims for financial accuracy, coding accuracy, and cost containment coordination
Process claim reimbursements on behalf of carriers/reinsurers
Maintain accurate and detailed claim documentation
Meet established accuracy and turnaround time standards
Identify and recover overpaid claims through refund requests

Fulltime

Senior Stop Loss Auditor

A Connecticut based Medical Insurance company is seeking an experienced Senior S...

Location

United States

Salary:

75000.00 - 90000.00 USD / Year

Daley and Associates

Expiration Date

Until further notice

Requirements

3+ years of medical stop loss insurance experience at the Senior level (required)
Experience auditing stop loss or first-dollar medical claims
Strong knowledge of: Plan Documents and Stop Loss policies, Reinsurance contracts, Medical terminology and coding (ICD-10, HCPCS, CPT-4)
Ability to work independently in a remote environment while collaborating with a team

Job Responsibility

Lead audits of complex and high-cost medical stop loss claims for assigned clients
Interpret and apply Plan Documents and Stop Loss policy provisions
Evaluate reimbursement submissions and render claim determinations
Verify eligibility, financial accuracy, and medical coding compliance
Review claims for coordination with cost containment programs
Ensure claims are processed within established accuracy and turnaround standards
Identify and pursue recovery of overpaid claims
Maintain detailed audit documentation and reporting
Partner with TPAs, carriers, and internal teams throughout the approval process
Support cross-functional collaboration and knowledge sharing across teams

Fulltime

Global Benefits Lead

We are looking for a Global Benefits Lead to join our People team. In this role,...

Location

United States , San Francisco; New York City

Salary:

180000.00 - 220000.00 USD / Year

Vercel

Expiration Date

Until further notice

Requirements

8+ years of experience building and managing global benefits programs at a scaling company
Experience supporting a distributed workforce across multiple countries, with significant reliance on EOR partners
Direct experience evaluating, implementing, or managing a U.S. self-insured health plan
Strong expertise in U.S. health and welfare, 401k administration, and leave compliance, with working knowledge of international statutory benefits
Experience managing benefits budgets and building financial models to guide program decisions
Ability to translate complex benefits structures into clear, effective communication for employees and leadership
Experience building scalable processes and systems to support rapid growth

Job Responsibility

Develop Vercel’s global benefits philosophy and strategy across health and welfare, retirement (401k and global equivalents), leave of absence, time off, stipends, and wellness programs
Evaluate, design, and implement a potential U.S. self-insured health plan, including financial modeling, risk assessment, vendor selection (TPA, stop-loss, PBM), and compliance considerations
Partner with EOR providers to design and manage benefits programs, ensuring local compliance while maintaining a consistent global philosophy
Lead analysis, benchmarking and implementation for benefits in new entities from global expansion
Lead global open enrollment cycles end-to-end, including vendor coordination, systems readiness, employee communication, and reporting
Manage the global benefits budget, including forecasting, cost analysis, and scenario modeling to support executive decision-making
Oversee broker and vendor relationships, negotiating contracts and holding partners accountable to performance and service standards
Administer employee stipend programs (wellness, remote work, educational reimbursement) with clear governance and operational rigor
Ensure compliance with U.S. and international benefits and leave regulations, proactively mitigating risk as we expand
Build and document scalable processes that support continued global growth

What we offer

Competitive compensation package, including equity
Inclusive Healthcare Package
Learn and Grow - we provide mentorship and send you to events that help you build your network and skills
Flexible Time Off
We will provide you the gear you need to do your role, and a WFH budget for you to outfit your space as needed

Fulltime

A&H Account Manager / Senior Account Manager

BHSI has an exciting opportunity to join the Accident & Health Account Managemen...

Location

United States , Atlanta, GA/Boston, MA/Indianapolis, IN/Plymouth Meeting, PA

Salary:

85000.00 - 140000.00 USD / Year

Berkshire Hathaway Specialty Insurance

Expiration Date

Until further notice

Requirements

3-7+ years of Employer Stop Loss Account Management experience is preferred
Excellent written and verbal communication
Client services experience
Relationship building
Highly organized and capable of task-management
Goal oriented
Negotiation skills
Skilled with Word, Excel, PDF programs and very capable of learning internal systems and reporting
David Young/ Connexure system experience preferred

Job Responsibility

Policyholder Service and Retention
Renewal process management
Client service
Sales support
New business implementation
Retention and new business reporting
Producer Support and Management
Agent appointment
Producer agreement development
Underwriting tech coordination

What we offer

Comprehensive Health, Dental and Vision benefits
Disability Insurance (both short-term and long-term.)
Life Insurance (for you and your family)
Accidental Death & Dismemberment Insurance (for you and your family)
Flexible Spending Accounts
Health Reimbursement Account
Employee Assistance Program
Retirement Savings 401(k) Plan with Company Match
Generous holiday and Paid Time Off
Tuition Reimbursement

Fulltime

Medical Claims Analyst

We are looking for a detail-oriented Medical Claims Analyst to join our team in ...

Location

United States , Cincinnati

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

3+ years of medical claims adjudication experience in a self‑funded health plan environment
Direct experience supporting union, Taft‑Hartley, or collectively bargained benefit plans
Strong knowledge of medical terminology, CPT, HCPCS, and ICD‑10 codes
Solid understanding of ERISA and self‑funded plan administration
Experience interpreting plan documents and SPD language
Proficiency with claims systems and Microsoft Office (Excel, Word, Outlook)
Strong analytical, problem‑solving, and attention‑to‑detail skills
Excellent written and verbal communication skills

Job Responsibility

Review, analyze, and adjudicate medical claims for a self‑funded union health plan in accordance with plan documents, SPD, and collective bargaining agreements
Interpret benefits, eligibility, coverage limits, and exclusions to ensure accurate claim determination
Apply applicable fee schedules, contracts, and network guidelines
Identify and resolve claim discrepancies, overpayments, coordination of benefits (COB), subrogation, and eligibility issues
Research, process, and respond to participant, provider, and union inquiries regarding claim status and benefit interpretation
Prepare written explanations of benefits (EOBs) and appeal decisions with clear, compliant documentation
Assist with first‑ and second‑level appeals, audits, and regulatory requests
Ensure compliance with ERISA, HIPAA, ACA, and other applicable regulations
Collaborate with internal teams, trustees, TPAs, stop‑loss carriers, and network vendors as needed
Maintain accurate claim documentation and meet established productivity and quality standards

What we offer

medical, vision, dental, and life and disability insurance
company 401(k) plan

Fx Options Trader

As part of the Finance team, you'll help shape Barclays' financial strategy thro...

Location

United States , New York

Salary:

160000.00 - 250000.00 USD / Year

Barclays

Expiration Date

Until further notice

Requirements

Extensive coverage of broad suite of clients in the US across hedge funds, corporates, real money along Sales workforce and provide continuous market trading color
Responsible for EOD PNL flash and accounting + team market commentary sent daily
Go to trader in the US for the desk risk runs and responsible for enhancing our risk batches and efficiency of our runs
Manage a global options book taking ownership of the front to back franchise including client engagement, pricing, and risk management
Review desk positions (i.e. risk and P&L) for adequacy and appropriateness each day
Communicate with overall global business head to ensure they are aware of client flows and key risk positions
Development and implementation of trading strategies that align with the bank's risk appetite, investment objectives, and market conditions, and monitoring of market movements to adjust trading strategies accordingly
Execution of trades on behalf of the bank, or proprietary trading desks, while adhering to the bank's trading strategies and risk parameters
Maintenance of accurate and timely trading records, prepare daily and monthly trading reports, and contribute to the evaluation of the overall trading strategy
Monitoring and analysis of global financial markets, economic indicators, news, and geopolitical events to identify trading opportunities and assess market risks

Job Responsibility

To buy and sell financial instruments, such as bonds, stocks, and derivatives, to generate revenue for the bank by the analysis of market conditions, execution of trades, and management of risk

What we offer

Incentives pursuant to Barclays Employee Referral Program
Hybrid working
Structured approach to hybrid working
Wellness center equipped with modern amenities, including fitness centres offering a variety of classes and services
Health center provides a range of services, including primary and urgent care, wellness exams, health coaching, and vaccinations
Office features a variety of sophisticated dining options, including a colleague restaurant and a private executive dining room

Fulltime

Stop Loss Coordinator

Robert Half

Location:
United States , Feasterville-Trevose

Category:
Insurance

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
March 13, 2026

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Stop Loss Coordinator

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Location:United States , Feasterville-Trevose

Category:Insurance

Contract Type:Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:March 13, 2026

Looking for more opportunities? Search for other job offers that match your skills and interests.

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Location:
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Contract Type:
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Job Posted:
March 13, 2026