Stop-Loss Analytics & Reporting Specialist

Jobtailor; Connecticut; On-site; USD 60,000 - 90,000; Full time

Job summary

Jobtailor in Connecticut seeks a detail-oriented Stop Loss Reporting Specialist to monitor and manage reporting activity for assigned clients, analyze data from carriers and portals, and maintain stop loss analytics. You will ensure timely submissions and accurate data across multiple reporting dashboards.

Responsibilities include producing monthly, quarterly, and annual stop loss reporting, supporting renewal initiatives, and collaborating with carriers, TPAs, PBMs, and internal consultants to

Qualifications

• High school diploma required.
• Some college coursework preferred.
• Must obtain and maintain Life/Accident and Health Insurance Agent License.
• Two to five years of experience in employee benefits, stop loss administration, carrier operations, claims analysis, or related field preferred.
• Strong analytical and problem-solving skills.
• Advanced Excel and reporting skills.
• Excellent organizational and tracking abilities with strong attention to detail.
• Ability to manage multiple deadlines and prioritize time-sensitive issues.
• Excellent oral and written communication skills.
• Strong follow-through and escalation management skills.
• Experience with stop loss carriers, TPAs, PBMs, or self-funded plans preferred.
• Understanding of large claim reporting and reimbursement processes preferred.
• Proficient in Microsoft Office Suite and Agency Management Systems.
• Working knowledge of self-funded and stop loss arrangements.

Responsibilities

• Monitor and manage all stop loss reporting activity for assigned clients.
• Download and review reports from carrier, TPA, PBM, and stop loss carrier portals.
• Analyze medical, pharmacy, eligibility, and stop loss claim data for self-funded clients.
• Maintain stop loss tracking databases, reporting logs, and standardized analytics templates.
• Coordinate required documentation and reporting submissions to stop loss carriers within contract timelines.
• Follow up on pended or denied claims to ensure adjudication and reimbursement.
• Coordinate with stop loss carriers, TPAs, PBMs, and internal consultants on reimbursement tracking and claim resolution.
• Create and maintain client reporting, financial exhibits, and stop loss analytics.
• Produce monthly, quarterly, and annual stop loss reporting.
• Manage monthly claims dashboards for assigned clients.
• Review high-cost claimant activity and provide month-over-month updates on claim costs, diagnoses, treatment, prognosis, and future exposure.
• Validate data and proactively resolve discrepancies and reporting issues.
• Support renewal, marketing, and strategic consulting initiatives with large claim summaries and reimbursement analyses.
• Enhance stop loss monitoring workflows, reporting tools, and quality-control procedures.
• Contribute to advanced claims analytics, trend analysis, cost-driver and utilization insights.
• Build and maintain standardized dashboards and executive-level financial exhibits.
• Support employer and employee contribution modeling and benefit-plan financial analysis.
• Partner with internal teams to improve data integrity and streamline reporting.
• Contribute to ad hoc analytical projects, anomaly detection, performance monitoring, cost-saving opportunities, and coverage-gap identification

Skills

Analytical skills

Problem-solving skills

Advanced Excel

Organizational skills

Communication skills

Attention to detail

Time management

Multitasking

Data validation

Reporting skills

Education

High school diploma

Some college coursework

Tools

Microsoft Office Suite

Agency Management Systems

Stop Loss Carrier Portals

TPA Portals

PBM Portals

Job description

Jobtailor in Connecticut seeks a detail-oriented Stop Loss Reporting Specialist to monitor and manage reporting activity for assigned clients, analyze data from carriers and portals, and maintain stop loss analytics. You will ensure timely submissions and accurate data across multiple reporting dashboards.

Responsibilities include producing monthly, quarterly, and annual stop loss reporting, supporting renewal initiatives, and collaborating with carriers, TPAs, PBMs, and internal consultants to