Remote Stop-Loss Claims Specialist I

Allied Benefit Systems, LLC; Chicago (IL); Remote; USD 32,000 - 33,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Generous Paid Time Off

Tuition Reimbursement

EAP

Job summary

Allied Benefit Systems seeks a Stop Loss Claims Specialist I for a fully remote position. You will prepare and file medical stop loss claims, follow up with carriers, and manage reimbursements while maintaining documentation.

This role supports timely, accurate claim processing and carrier communications. The position requires a high school diploma, 1–2 years of claims experience in a self-funded environment, strong Excel skills, and clear collaboration with internal teams and carriers.

Qualifications

• 1-2 years of claims experience in a self-funded environment.
• Knowledge of Stop Loss concepts and policy provisions.
• Ability to interpret contracts and SPD documents.
• Proficiency with Microsoft Excel and Office.
• Strong analytical and problem-solving skills.
• Excellent written and verbal communication.
• High attention to detail and organization.

Responsibilities

• Compile and submit claim reports with required documentation.
• Monitor claims status and follow up with stop loss carriers.
• Respond to requests from carriers promptly with thorough information.
• Coordinate with internal teams to resolve issues.
• Prepare initial, subsequent, and year-end claim filings.
• Appeal denials or reductions of reimbursements.

Skills

2 years claims experience

Stop Loss terminology

Interpreting Stop Loss contracts

Microsoft Excel proficiency

Analytical skills

Communication skills

Detail oriented

Education

High School diploma

Some college

Tools

Microsoft Excel

Job description

Allied Benefit Systems seeks a Stop Loss Claims Specialist I for a fully remote position. You will prepare and file medical stop loss claims, follow up with carriers, and manage reimbursements while maintaining documentation.

This role supports timely, accurate claim processing and carrier communications. The position requires a high school diploma, 1–2 years of claims experience in a self-funded environment, strong Excel skills, and clear collaboration with internal teams and carriers.