Remote Stop-Loss Claims Specialist

Imagine360; United States; On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Health insurance

PTO 20 days + 10 holidays

Tuition reimbursement

401k company contributions

Professional development

Job summary

Imagine360 is seeking a Stop Loss Claims Specialist to coordinate tracking, submission and documentation of stop loss claims. The role emphasizes accuracy, timely reporting, and carrier interactions while maintaining a comprehensive understanding of plan documents.

The position is 100% remote in the United States, with responsibilities spanning claims management, customer service, and quality assurance to support self-funded plans and stop-loss processes.

Qualifications

• High school diploma or equivalent required; associates degree preferred.
• 3+ years in medical claims administration, stop-loss filings, or health insurance operations.
• Experience with self-funded medical plans and stop-loss concepts (specific/aggregate).

Responsibilities

• Coordinate stop loss claims submission to carriers and data entry.
• Maintain documentation and reporting aligned with internal standards and carrier expectations.
• Produce regular reports on open filings, reimbursements and aging items.
• Assist with audits, carrier reviews, and process improvements.

Skills

organization

problem solving

analytical skills

attention to detail

multitasking

Education

High School Diploma or GED

Associate degree (preferred)

Tools

Microsoft Office

Job description

Imagine360 is seeking a Stop Loss Claims Specialist to coordinate tracking, submission and documentation of stop loss claims. The role emphasizes accuracy, timely reporting, and carrier interactions while maintaining a comprehensive understanding of plan documents.

The position is 100% remote in the United States, with responsibilities spanning claims management, customer service, and quality assurance to support self-funded plans and stop-loss processes.