Remote Stop-Loss Filing Coordinator | Claims & Compliance

Pointchealth; Northern (KY); Hybrid; USD 45,000 - 50,000; Full time

Benefits offered by this job

Health insurance

401(k) retirement plan with employer-m

HSA

FSAs

Paid time off (PTO)

Employee Assistance Program (EAP)

Job summary

Point C Health is seeking a detail-oriented Stop Loss Filing Coordinator to join our team. This role manages end-to-end stop loss claims, acts as liaison with clients and carriers, and ensures accurate submissions and timely responses.

Responsibilities include preparing claims, maintaining records, supporting renewals, and generating reports, with a focus on process improvement and regulatory compliance. Compensation ranges disclosed with benefits apply.

Qualifications

• Strong attention to detail and organizational skills with the ability to manage multiple tasks and deadlines.
• Experience working in healthcare, insurance, or third-party administration (TPA) settings, particularly in stop-loss claims or underwriting.
• Proficiency in Microsoft Office Suite, especially Excel for tracking and reporting.
• Strong verbal and written communication skills for both internal and external correspondence.
• Ability to interpret complex policy language and reconcile information across multiple documents.
• A proactive, problem-solving mindset and commitment to continuous process improvement.
• Prior experience working with stop-loss MGUs or carriers is a plus.

Responsibilities

• Prepare and submit stop-loss claims and supporting documentation with a focus on accuracy and eligibility verification.
• Coordinate with internal teams, clients, and stop-loss carriers to ensure timely and complete claim submissions.
• Maintain precise records of all claims activity, including correspondence and supporting documentation.
• Act as the primary point of contact between internal teams and stop-loss MGUs/carriers.
• Provide regular updates to clients and internal stakeholders regarding claim status, pending issues, and resolution timelines.
• Collaborate with Account Managers and Sales Executives to support quote renewals and policy reviews.
• Review and analyze stop-loss policies, quotes, applications, and plan documents to ensure alignment and consistency.
• Generate monthly financial data reports for internal and client-facing use.
• Maintain and update internal tracking spreadsheets for stop-loss claims activity.
• Identify opportunities to streamline stop-loss filing processes and enhance overall efficiency.
• Participate in internal audits and contribute to team training and best practice development.
• Manage advanced funding requests in coordination with clients and stop-loss carriers.
• Support the broader stop-loss administrative function and ensure compliance with internal policies and regulatory requirements.

Skills

Attention to detail

Organizational skills

Communication

Policy interpretation

Problem solving

Stop-loss knowledge

Healthcare/insurance experience

Tools

Excel

Microsoft Office Suite

Job description

Point C Health is seeking a detail-oriented Stop Loss Filing Coordinator to join our team. This role manages end-to-end stop loss claims, acts as liaison with clients and carriers, and ensures accurate submissions and timely responses.

Responsibilities include preparing claims, maintaining records, supporting renewals, and generating reports, with a focus on process improvement and regulatory compliance. Compensation ranges disclosed with benefits apply.