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Remote Stop Loss Insurance Jobs in Florida (NOW HIRING)

Steer

Technical Support Specialist - Remote

Tampa, FL · On-site +1

... stop worrying about marketing and customer retention. Steer began as an online directory for ... Medical, Dental and Vision insurance within 30 days * 100% employer-paid medical insurance * Equity ...

Steer

Technical Support Specialist - Remote

Miami, FL · On-site +1

... stop worrying about marketing and customer retention. Steer began as an online directory for ... Medical, Dental and Vision insurance within 30 days * 100% employer-paid medical insurance * Equity ...

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All JobsStop Loss Insurance JobsRemote Stop Loss Insurance JobsRemote Stop Loss Insurance Jobs in Florida

Remote Stop Loss Insurance information

What are the key skills and qualifications needed to thrive as a remote stop loss insurance specialist, and why are they important?

To excel as a Remote Stop Loss Insurance Specialist, you need expertise in health insurance underwriting, risk assessment, and policy analysis, often supported by a background in insurance or finance. Familiarity with industry-standard claims management systems, CRM platforms, and regulatory compliance tools is essential. Strong analytical thinking, attention to detail, and effective written communication are crucial soft skills for success in a remote environment. These abilities ensure accurate risk evaluation, regulatory adherence, and clear client interactions, which are critical for managing high-value stop loss insurance contracts.

What is remote stop loss insurance?

Remote stop loss insurance is a type of coverage designed to protect self-funded employers from large or catastrophic claims, but managed and administered through digital or remote platforms. This insurance reimburses employers for claims that exceed a predetermined limit, helping them manage risk and avoid significant financial loss. The 'remote' aspect refers to the use of online tools and services for policy management, claims processing, and communication, allowing for flexible and efficient administration without the need for in-person meetings. This is particularly beneficial for companies with distributed teams or those seeking streamlined, technology-driven solutions.

What is the difference between Remote Stop Loss Insurance vs Remote Underwriter?

AspectRemote Stop Loss InsuranceRemote Underwriter
CredentialsInsurance licenses, actuarial knowledgeInsurance licenses, underwriting certifications
Work EnvironmentInsurance companies, brokers, remoteInsurance companies, remote or office
Industry UsageHealth and self-funded plansInsurance policy assessment and risk evaluation

Remote Stop Loss Insurance professionals focus on providing coverage for self-funded health plans, managing risk, and setting policy terms. Remote Underwriters evaluate insurance applications, assess risks, and determine policy eligibility. While both roles require insurance knowledge and licenses, Stop Loss Insurance specialists concentrate on risk management for health plans, whereas Underwriters focus on evaluating individual applications. Understanding these differences helps clarify career paths and job expectations in the insurance industry.

What are some common challenges faced by professionals working in remote stop loss insurance roles?

One common challenge in remote stop loss insurance roles is maintaining clear and effective communication with underwriters, brokers, and clients, since much of the collaboration happens virtually. Additionally, staying updated on changing regulations and market trends requires proactive self-learning and digital resourcefulness. Managing sensitive data securely and ensuring timely turnaround on complex claims or policy analysis can also be demanding when working remotely. Building strong relationships with team members and clients, despite the lack of in-person interaction, is key to long-term success in this field.
What are the most commonly searched types of Stop Loss Insurance jobs in Florida? The most popular types of Stop Loss Insurance jobs in Florida are:
What are popular job titles related to Remote Stop Loss Insurance jobs in Florida? For Remote Stop Loss Insurance jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Remote Stop Loss Insurance jobs in Florida look for? The top searched job categories for Remote Stop Loss Insurance jobs in Florida are:
What cities in Florida are hiring for Remote Stop Loss Insurance jobs? Cities in Florida with the most Remote Stop Loss Insurance job openings:
Remote Stop Loss Insurance jobs near you

PIP Coverage and Qualification Adjuster

United Automobile Insurance Company

Miami, FL • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 25 days ago

Job description

COMPANY OVERVIEW
Founded in 1989, United Automobile Insurance Company is an innovative and established organization looking for [a] Coverage and Qualification Adjuster(s) to join our team. Family-owned, UAIC, is one of the largest privately held property and casualty insurance companies in the United States. The key to our growth and success is a commitment to providing quality service to our agents and customers, by providing disciplined underwriting, and strategic claims handling. Our ongoing efforts to invest substantial resources in personnel and technology are the foundation of our promise of assuring maximum efficiency and specialized operations in the industry. We are proud that our independent agents and customers have recognized our dedication by making UAIC the market leader in every state where we conduct business.
Auto PIP Claims experience required - This is a fully remote opportunity, and the ideal candidate will have an active adjuster's license, in Florida or Texas.
SCOPE:
As a Coverage and Qualification Adjuster, you will be responsible for reviewing and processing Personal Injury Protection claims, ensuring compliance with company policies and state regulations. This role involves assessing the validity of claims, determining coverage limits, and facilitating timely and accurate settlements.
DUTIES:
  • Review and assess PIP claims to determine coverage eligibility.
  • Analyze medical records, police reports, and other relevant documents to evaluate the extent of injuries and to establish proof of loss.
  • Interpret insurance policies, contracts, and state regulations to determine the extent of coverage applicable to each claim.
  • Communicate with claimants, medical professionals, attorneys, and other parties involved in the claim process to gather necessary information and documentation.
  • Provide clear and concise explanations of coverage decisions to claimants.
  • Conduct interviews with claimants to gather necessary information that supports an objective final disposition of the claims. These interviews may be conducted under oath or via phone.
  • Maintain accurate and organized claim files with all pertinent information, including correspondence, medical records, and assessment reports.
  • Issue payments for approved claims in accordance with company policies.
  • Ensure compliance with state laws, regulations, and company policies in all claim handling activities.
  • Generate and submit reports on claims activity, trends, and performance metrics.
  • Identify and investigate potentially fraudulent activities related to PIP claims.
  • Collaborate with the special investigation unit (SIU) when fraud is suspected.
  • Provide excellent customer service by addressing inquiries, concerns, and providing timely updates to claimants.
  • Prepare reports and documentation for internal purposes, regulatory compliance, and potential legal proceedings.

EDUCATION:
  • Associate or bachelor's degree preferred and/or a minimum of 3 years of related work experience, preferably with PIP claims.
  • Active Adjuster's license required

SKILLS & EXPERIENCE:
  • Bilingual (English & Spanish) preferred
  • Knowledge of insurance principles, policies, and procedures.
  • Strong analytical, negotiation, and communication skills.
  • Ability to work independently and efficiently manage a caseload.
  • Proficient in Guidewire, Word, Excel, Windows-based applications and internet usage.
  • Must be familiar with forms, procedures, regulations, coverages, and claims processes.
  • Must be able to exercise good judgment and state opinions assertively.
  • Must be able to write and speak clearly and concisely.
  • Must be able to perform work effectively in a highly intense environment and handle multiple tasks and demands simultaneously.
  • Must illustrate analytical skills to identify, gather, and organize information.
  • Must be able to work independently in a team environment.

BENEFITS:
  • 401(k) Retirement Savings Plan with employer match.
  • Comprehensive Medical, Prescription Drug, Vision, and Dental Insurance
  • Paid Time Off, Holidays, and Leave programs.
  • Flexible spending accounts
  • Basic Life Insurance and Voluntary Life/ADD
  • Short Term and Long-Term Disability
UAIC participates in the E-Verify program to confirm the employment eligibility of all newly hired employees. For more information about E-Verify, please visit https://www.e-verify.gov/.
UAIC is an Equal Opportunity Employer and is committed to the principle of equal employment opportunity for all employees. All employment decisions at UAIC are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion, or belief, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. PIP Coverage and Qualification Adjuster

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