Lead the team that makes sure high-dollar medical claims are handled right, on time, and in line with strategy. In this role, you own the day to day operations of the Stop Loss department while driving efficiency, accuracy, and process improvement across the board.
About Allied Benefit Systems
Allied Benefit Systems is a national healthcare benefits administrator that partners with employers to design and manage flexible, self funded health plans. The company focuses on smarter plan design, cost control, and responsive service that supports both clients and members. As a Stop Loss leader, you will help protect client dollars and strengthen Allied’s reputation for disciplined, high quality operations.
Schedule
- Full time, fully remote role
- Standard business hours (specific schedule may vary by team)
- Remote friendly culture with a focus on accountability, communication, and performance
- Requires reliable cable or fiber internet with at least 100 Mbps download and 25 Mbps upload speeds
What You’ll Do
- Manage the day to day operations of the Stop Loss department, including workflow, staffing, systems, procedures, and reporting
- Monitor all claim filings, specific and aggregate, to ensure timely and accurate processing and reimbursements
- Track stop loss claim filings, reimbursements, and advance funding claims to keep audit metrics and department performance on target
- Assess and refine processes for efficiency, quality, and alignment with corporate directives and strategy
- Design and implement policies and procedures that support consistent, compliant, and effective operations
- Collaborate with cross functional teams to meet business objectives and performance standards
- Perform weekly audits of specific claims to confirm proper filing and reimbursement
- Coordinate reprocessing of claims based on carrier negotiations and handle aggregate claim filings and reimbursements
- Oversee adjustments for claims that should be applied to prior contracts
- Lead, coach, and develop your team, including one on one meetings, performance appraisals, growth planning, and hiring new talent
- Set clear expectations, provide training and resources, and deliver timely, constructive feedback
- Troubleshoot daily operational issues and drive a sense of urgency and ownership across the team
- Work on special projects and other duties as assigned
What You Need
- Bachelor’s degree or 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 demonstrated leadership success
- Intermediate experience with Microsoft Word, Excel, and PowerPoint
- Group health insurance or benefits experience preferred
- Excellent written and verbal communication skills
- Strong decision making, problem solving, and analytical skills
- Proven ability to manage teams, set direction, and hold people accountable
- Comfortable working in a fast paced environment with evolving priorities
Benefits
- Salary range of 70,000 to 75,000 dollars, based on experience and qualifications
- Comprehensive Total Rewards package
- Medical, Dental, and Vision insurance
- Life and Disability insurance
- Generous Paid Time Off
- Tuition Reimbursement
- Employee Assistance Program (EAP)
- Technology stipend to support your remote work setup
If you are ready to move from individual stop loss expertise into leading the entire function, this is a strong next step.
Give your leadership and stop loss experience a bigger stage and a fully remote setup that actually works for your life.
Happy Hunting,
~Two Chicks…