Stop Loss Training Lead (Fully Remote)

Personify Health; United States; Remote; USD 100,000 - 150,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Unlimited PTO

Mental health support

Retirement planning

Career development

Job summary

Personify Health in the United States is seeking an experienced stop loss professional to act as the department's stop loss authority, interpret contracts, and drive reimbursements to resolution. You will lead audits, implement corrective actions, and guide process improvement initiatives.

The role requires 3-5 years in stop loss or self-funded health plan administration, advanced knowledge of stop loss concepts, and strong Excel/reporting tool skills to analyze data and ensure accurate claims

Qualifications

• 3-5 years of stop loss or self-funded health plan administration experience.
• Advanced knowledge of stop loss, contract interpretation, and claims processing.
• Proficiency in Excel and reporting tools with strong auditing and data analysis skills.

Responsibilities

• Act as the department's stop loss authority, interpreting contracts and driving reimbursements to resolution.
• Conduct audits, implement corrective actions, and lead process improvement initiatives.

Skills

Stop loss knowledge

Contract interpretation

Auditing

Data analysis

Excel proficiency

Tools

Excel

Reporting tools

Job description

• Act as the department's stop loss authority, interpreting contracts and driving reimbursements to resolution.
• Conduct audits, implement corrective actions, and lead process improvement initiatives.

Requirements:

• 3-5 years of stop loss or self-funded health plan administration experience.
• Advanced knowledge of stop loss, contract interpretation, and claims processing.
• Proficiency in Excel and reporting tools with strong auditing and data analysis skills.
• Comprehensive medical and dental benefits from day one.
• Unlimited PTO, mental health support, and retirement planning.
• Professional development and career progression support.

Personify Health

Personify Health offers a personalized health platform that brings health plan administration, holistic wellbeing solutions, and comprehensive care navigation together. The company is mission-driven and focused on empowering people to lead healthier lives, with a culture that values diverse perspectives.