Manager – Stop Loss Claims – Remote
Core
Lead daily stop loss claims operations, drive service excellence, and manage a high-performing team to deliver exceptional customer experience for self-funded medical plans.
Role type
Manager, Stop Loss Claims
Builds
Claims operations, customer service, and process improvements for self-funded medical plans
Domain
Health Insurance / Claims Administration
Deliverable
client delivery
Required skills
Stop loss claims administration, team leadership, compliance management, vendor management, cost containment strategies, medical terminology, analytical problem-solving
Preferred skills
Connexure/ESL experience, industry engagement (SIIA, SPBA), professional designations, knowledge of cost containment strategies
Technologies
Connexure, ESL, Microsoft Office
Responsibilities
Lead day-to-day stop loss claims operations to ensure quality and timely service delivery; Monitor performance metrics and implement process improvements; Handle escalated claims, payment approvals, and complaint resolution; Lead, coach, and develop a high-performing claims team; Partner with Legal, Compliance, and business partners to ensure regulatory compliance
Seniority
Manager, hands-on leadership
