Accountabilities:

Manage the financial and administrative operations of the stop loss program, including premium administration, policy issuance, licensing, reconciliations, and operational controls.
Process premium receipts, lockbox transactions, and ACH payments, ensuring accurate allocation of premiums to the appropriate employer groups and insurance policies.
Reconcile enrollment records, expected premiums, and received payments, investigating and resolving shortages, overpayments, unapplied cash, delinquent premiums, and other financial discrepancies.
Coordinate return premium transactions, commissions, override payments, claim payments, and other financial activities in collaboration with Finance and Accounts Payable teams.
Maintain accurate supporting documentation and reconciliation records for all financial transactions.
Perform monthly premium reconciliations and support month-end closing activities, carrier bordereaux, financial reporting, and other program-related reports.
Manage policy administration following final underwriting approval, including sold-case requirements, policy and form selection, document preparation, amendments, endorsements, and outstanding-item tracking.
Review policy documentation against approved underwriting terms, verifying deductibles, aggregate provisions, contract basis, lasers, exclusions, effective dates, terminal liability provisions, and special endorsements.
Identify and escalate discrepancies in policy terms or documentation before issuance to ensure contractual accuracy.
Coordinate policy issuance activities across Stop Loss Specialists while maintaining documented procedures, quality assurance standards, and status reporting.
Administer agency and producer licensing, carrier appointments, renewals, state-specific requirements, regulatory correspondence, and related documentation.
Maintain due diligence records for third-party administrators and producers while supporting applicable approval and compliance processes.
Develop and maintain operational procedures, reconciliation processes, exception reports, internal controls, and audit documentation covering premium, policy, and licensing activities.
Support internal, financial, and carrier audits, ensuring that identified discrepancies and exceptions are documented and resolved promptly.
Prepare operational reports, monitor performance, and identify opportunities to improve accuracy, efficiency, transparency, and internal controls.
Coordinate workflows across Stop Loss Specialists and internal stakeholders, escalating significant underwriting, financial, contractual, or compliance matters to the appropriate leadership.
Recommend improvements to operational processes, systems, and controls in collaboration with Stop Loss leadership and relevant departments.
Perform additional responsibilities as assigned and comply with applicable workplace, data security, and regulatory requirements.

Requirements

At least 3 years of professional experience in insurance operations, premium administration, accounting, financial reconciliation, policy administration, or a related field.
Working knowledge of self-funded medical plans, employer stop loss insurance terminology, insurance contracts, and related operational processes.
Strong analytical and reconciliation skills, with the ability to accurately manage and interpret premium, enrollment, policy, and financial data.
Demonstrated ability to understand insurance policy provisions and underwriting terms, identify discrepancies, and determine when additional review or escalation is necessary.
Experience managing financial or administrative processes involving established controls, documentation standards, and recurring deadlines.
Exceptional attention to detail and a commitment to maintaining accurate, complete, and audit-ready records.
Strong organizational and time-management abilities, with the capacity to manage multiple workflows and competing priorities.
Excellent written and verbal communication skills, with the ability to collaborate effectively with insurance carriers, TPAs, producers, and internal teams across Finance, Underwriting, and Claims.

How Jobgether works

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Why Apply Through Jobgether?

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

#LI-CL1