Remote Stop-Loss Claims Expert

Imagine360, LLC; United States; Remote; USD 55,000 - 75,000; Full time

Benefits offered by this job

Health plan options

Company paid premiums for disability &

life insurance

Parental Leave Policy

20 days PTO to start / 10 Paid Vacays

Tuition reimbursement

401k company contribution

Professional development opportunities

Diversity and inclusion initiatives

Job summary

Imagine360 is seeking a Stop Loss Representative to coordinate tracking, monitoring, documenting, and submission of stop loss claims. This 100% remote role requires maintaining thorough understanding of plan documents within scope and delivering timely, accurate reporting.

You will manage stop loss filings, carrier questions, and reporting while supporting the Finance Department and ensuring high-quality customer service and data integrity.

Qualifications

• Experience with medical claims administration or health insurance operations is preferred.
• Experience with stop‑loss filings or high‑dollar medical claims is preferred.

Responsibilities

• Coordinate stop loss claims submission to carriers.
• Enter stop loss claims into designated databases.
• Research and resolve stop loss carrier questions.
• Support the Finance Department with funding processes.
• Maintain detailed records of filings, reimbursements and carrier determinations.
• Produce regular reports on open filings and aging items.
• Assist with audits and process improvements.
• Provide excellent customer service to internal and external stakeholders.

Skills

Microsoft Office

Excel

Mathematical aptitude

10-key typing

Organizational skills

Communication skills

Education

High School Diploma or GED

Associate degree in Business Administration/Healthcare Administration/Finance

Tools

None

Job description

Imagine360 is seeking a Stop Loss Representative to coordinate tracking, monitoring, documenting, and submission of stop loss claims. This 100% remote role requires maintaining thorough understanding of plan documents within scope and delivering timely, accurate reporting.

You will manage stop loss filings, carrier questions, and reporting while supporting the Finance Department and ensuring high-quality customer service and data integrity.