Remote Stop-Loss Claims Specialist: Aggregate & Denial

Allied; United States; Hybrid; USD 42,000 - 64,000; Full time

Job summary

Allied is seeking a claims specialist to prepare and submit stop loss claim reports and related documents. You will monitor statuses, appeal denials, audit positions, and coordinate with internal teams to resolve issues. The role requires 1–2 years in a self-funded environment and strong Excel capabilities.

The position offers a remote-friendly culture and a collaborative, process-driven environment designed to support success in a flexible work setup.

Qualifications

• 1–2 years of claims experience in a self-funded environment.
• Thorough knowledge of Stop Loss terminologies and concepts.
• Ability to interpret Stop Loss contracts and SPD.
• Proficient with Microsoft Excel (MS Office).
• Strong analytical and problem-solving skills.

Responsibilities

• Compile and submit claim reports and necessary documentation to file stop loss claims
• Monitor claim status and follow up with stop loss carriers
• Appeal denials or reduction of reimbursements by stop loss carriers
• Audit aggregate positions and track funding balance
• Communicate with internal departments to resolve claim issues
• Manage time to file aggregate accommodation, level funded, and final claim submissions

Skills

Analytical thinking

Problem solving

Tools

Microsoft Excel

Job description

Allied is seeking a claims specialist to prepare and submit stop loss claim reports and related documents. You will monitor statuses, appeal denials, audit positions, and coordinate with internal teams to resolve issues. The role requires 1–2 years in a self-funded environment and strong Excel capabilities.

The position offers a remote-friendly culture and a collaborative, process-driven environment designed to support success in a flexible work setup.