Stop Loss Filing Coordinator

Point C is seeking a detail-oriented and organized Stop Loss Filing Coordinator to 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.

Primary Responsibilities:

• 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.
• 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.
• 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.
• 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.
• 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.