Lead a specialized stop loss team from your home office while owning high impact claims operations. This role is built for a seasoned stop loss leader who can balance strategy, audit oversight, and day-to-day coaching without losing the details.
About Allied Benefit Systems
Allied Benefit Systems is a Chicago-based third-party administrator that partners with employers nationwide to design and manage self-funded health plans. The company focuses on flexible, cost-effective benefit solutions backed by strong operational performance and responsive client service. Allied’s remote-friendly culture lets experienced leaders drive results from anywhere while still feeling connected and supported.
Schedule
Full-time, fully remote position based out of Chicago, Illinois.
Standard weekday business hours in a computer-based environment.
Requires reliable high-speed internet via cable or fiber (at least 100 Mbps download / 25 Mbps upload) to support collaboration, reporting, and system access.
What You’ll Do
- Manage the day-to-day operations of the Stop Loss department, including workflow, staffing, systems, and reporting.
- Work closely with the Director of Stop Loss to set expectations, meet business goals, and drive innovation.
- Oversee all stop loss filings (specific and aggregate), reimbursements, and advance funding claims to ensure timely, accurate handling.
- Perform and oversee weekly audits of specific claims to confirm filings and reimbursements are correct.
- Maintain and improve tracking tools and logs for members over specific deductibles and stop loss activity.
- Coordinate reprocessing of claims based on carrier negotiations and contract details.
- Lead the filing of aggregate claims and secure corresponding reimbursements.
- Manage the cash flow impact of advance funding by selecting appropriate claims and monitoring paybacks.
- Request and review reporting for mid-year takeover stop loss policies.
- Assess existing processes and design/implement policies and procedures that improve efficiency and align with corporate strategy.
- Troubleshoot issues across teams and remove obstacles to keep operations running smoothly.
- Directly manage team members, including assignments, performance goals, one-on-ones, coaching, and performance reviews.
- Set clear expectations, provide training, and ensure quality standards and audit metrics are met.
- Attract, develop, and retain talent while fostering a culture of urgency, accountability, and collaboration.
- Take on special projects and additional duties as needed.
What You Need
- Bachelor’s degree or equivalent relevant work experience.
- At least 5 years of stop loss experience at a TPA or stop loss carrier.
- At least 3 years in a supervisory or management role with proven leadership results.
- Intermediate proficiency with Microsoft Word, Excel, and PowerPoint.
- Strong knowledge of group health insurance/benefits (preferred).
- Excellent written and verbal communication skills.
- Proven ability to manage operations, drive process improvements, and meet deadlines.
- Strong decision-making, problem-solving, and relationship-building skills.
- Comfortable leading in a fully remote environment with clear expectations and accountability.
Benefits
- Salary range of $70,000 to $75,000 per year, based on experience and qualifications.
- Fully remote role within a supportive, remote-first culture.
- Medical, Dental, Vision, Life, and Disability insurance.
- Generous Paid Time Off.
- Tuition Reimbursement and Employee Assistance Program (EAP).
- Technology stipend to support your home office setup.
If you’re already the “go-to” stop loss expert and ready to step into (or level up in) leadership with full remote flexibility, this is one to take seriously.
Step into a role where your decisions shape operations, protect clients, and develop a high-performing team.
Happy Hunting,
~Two Chicks…