Remote Stop-Loss Claims Specialist

godirect; United States; Remote; USD 45,000 - 75,000; Full time

Benefits offered by this job

Health, dental, vision and life保险

401(k) Savings plan - with generous匹配

Voya Retirement Plan - employer paid

Tuition reimbursement up to $5,250/y

Paid time off - 20 days + holidays

Paid volunteer time - 40 hours/yr

Job summary

Voya Financial is seeking a claims professional to review complex claims and provide direction for excess risk scenarios. You will respond to inquiries from managers, brokers, and administrators while mentoring junior staff and conducting audits.

The role emphasizes leadership, analytical problem-solving, and strong communication. A flexible, remote-friendly schedule is available across locations.

Qualifications

• Minimum 3-5 years of claims or insurance experience.
• Knowledge of industry related claim systems and practices.
• Must be proficient in MS Excel (macros, pivots and formulas).
• Proven analytical and problem-solving skills and attention to detail.
• Demonstrated leadership skills.
• Excellent interpersonal and negotiation skills.
• Excellent written and oral communication skills.

Responsibilities

• Review complex claims and/or situations and make informed decisions that may require judgment by providing directions on excess risk claims.
• Respond to internal and external claim or reporting inquiries from managers, brokers, general agents, and administrators.
• Provide direction, develop, train, and mentor less experienced claims staff, including completing audits and providing feedback.
• Manage claim suspense accounts to ensure accurate claim processing and financial reporting.
• Manage mid-policy period and year end audit.
• Assist in developing and implementing process improvement.
• Participate in department projects and special initiatives.
• Stop Loss Claims Systems Testing.
• Other duties and projects as assigned.

Skills

Claims experience

MS Excel

Analytical skills

Leadership

Communication skills

Negotiation skills

Education

High School Diploma or GED

Bachelor's degree preferred

Tools

Industry claim systems

Job description

Voya Financial is seeking a claims professional to review complex claims and provide direction for excess risk scenarios. You will respond to inquiries from managers, brokers, and administrators while mentoring junior staff and conducting audits.

The role emphasizes leadership, analytical problem-solving, and strong communication. A flexible, remote-friendly schedule is available across locations.