Stop-Loss Training Lead: Reimbursements & Optimization

Personify Health, Inc.; 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

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