Stop Loss Filing Lead New United States - Remote

Pointchealth; Mississippi; Remote; USD 50,000 - 70,000; Full time

Job summary

A leading company in the healthcare sector is seeking a detail-oriented Stop Loss Filing Coordinator. This role involves managing stop-loss claims, ensuring accurate submissions, and collaborating with various stakeholders. The ideal candidate will excel in a fast-paced environment and possess strong communication and analytical skills. Join a team that values innovation and strives for excellence in client service.

Benefits

Comprehensive medical, dental, vision, and life insurance coverage

401(k) retirement plan with employer match

Health Savings Account (HSA) & Flexible Spending Accounts (FSAs)

Paid time off (PTO) and disability leave

Employee Assistance Program (EAP)

Qualifications

• Strong attention to detail and organizational skills.
• Experience in healthcare, insurance, or TPA settings.

Responsibilities

• Prepare and submit stop-loss claims and documentation.
• Act as primary contact between internal teams and stop-loss carriers.
• Review and analyze stop-loss policies and documents.

Skills

Attention to Detail

Organizational Skills

Communication

Analytical Skills

Problem Solving

Education

Experience in Healthcare

Experience in Insurance

Experience in TPA Settings

Tools

Microsoft Office Suite

Excel

Job description

Point C is a National third-party administrator (TPA) with local market presence that delivers customized self-funded benefit programs. Our commitment and partnership means thinking beyond the typical solutions in the market – to do more for clients – and take them beyond the standard “Point A to Point B.” We have researched the most effective cost containment strategies and are driving down the cost of plans with innovative solutions such as, network and payment integrity, pharmacy benefits and care management. There are many companies with a mission. We are a mission with a company.

Point C is seeking a detail-oriented and organized Stop Loss Filing Coordinatorto join our growing team. This position plays a critical role in managing the end-to-end stop loss claims process—serving as a liaison between internal stakeholders, clients, and stop loss carriers. The ideal candidate thrives in a deadline-driven environment, demonstrates exceptional communication and analytical skills, and is comfortable navigating complex policy documentation and claim data.

Key Responsibilities:

Claim Preparation and Filing

• 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.

Communication and Coordination

• 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.

Data Management and Analysis

• 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.

Process Improvement

• 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.

Other Duties

• 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.

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.
• Comprehensive medical, dental, vision, and life insurance coverage
• 401(k) retirement plan with employer match
• Health Savings Account (HSA) & Flexible Spending Accounts (FSAs)

Paid time off (PTO) and disability leave

• Employee Assistance Program (EAP)

Equal Employment Opportunity: At Point C Health, we know we are better together. We value, respect, and protect the uniqueness each of us brings. Innovation flourishes by including all voices and makes our business—and our society—stronger. Point C Health is an equal opportunity employer and we are committed to providing equal opportunity in all of our employment practices, including selection, hiring, performance management, promotion, transfer, compensation, benefits, education, training, social, and recreational activities to all persons regardless of race, religious creed, color, national origin, ancestry, physical disability, mental disability, genetic information, pregnancy, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, and military and veteran status, or any other protected status protected by local, state or federal law.

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