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Stop Loss Analyst Jobs (NOW HIRING)

Brown & Brown, Inc.

Trainer Stop Loss Claims

$80K - $100K/yr

Review and Analyze Specific Stop Loss claims referred by auditors or as requested by clients and assist with over authorization reviews. * Audit Specific Stop Loss claims during peak periods.

Berkley

Stop Loss Underwriter

Trenton, NJ · Remote

$90K - $110K/yr

With our entrepreneurial culture and a strong emphasis on analytics, we can help employers better manage their risk. We offer a broad range of products, including employer stop loss, benefit captives ...

Novacore

Sr. Underwriter, Stop Loss

Conshohocken, PA · On-site

$96K - $114K/yr

We specialize in tailored solutions for niche industries, powered by advanced analytics, modern ... Underwriter, Stop Loss The Sr. Medical Stop-Loss Underwriter is a pivotal team member responsible ...

Brown & Brown Insurance

Trainer Stop Loss Claims

$80K - $100K/yr

Review and Analyze Specific Stop Loss claims referred by auditors or as requested by clients andassistwith over authorization reviews. * Audit Specific Stop Loss claims during peak periods. * Ensure ...

Acrisure

Stop Loss Underwriter

Las Vegas, NV · On-site +1

$60K - $85K/yr

Analyze emerging large claims and assess recurrence risk * Underwrite new employer groups seeking stop loss coverage * Analyze renewal performance and determine rate adjustments * Balance ...

Novacore

Sr. Underwriter, Stop Loss

Conshohocken, PA · On-site

$96K - $114K/yr

We specialize in tailored solutions for niche industries, powered by advanced analytics, modern ... Underwriter, Stop Loss The Sr. Medical Stop-Loss Underwriter is a pivotal team member responsible ...

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Stop Loss Analyst information

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$33K

$80.8K

$105.5K

How much do stop loss analyst jobs pay per year?

As of Sep 4, 2026, the average yearly pay for stop loss analyst in the United States is $80,750.00, according to ZipRecruiter salary data. Most workers in this role earn between $73,000.00 and $91,000.00 per year, depending on experience, location, and employer.

What is a stop loss analyst?

A Stop Loss Analyst is a professional who reviews and manages stop loss insurance policies, which are designed to protect organizations from catastrophic or unpredictable high-cost claims. They analyze claims data, evaluate risk, and ensure that claims submitted fall within the policy's terms and conditions. Their role often includes working with underwriters, brokers, and clients to resolve claims issues, ensure compliance, and help manage overall healthcare costs for employers who self-fund their health plans.

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

To thrive as a Stop Loss Analyst, you need a strong understanding of health insurance, risk assessment, and data analysis, typically supported by a bachelor's degree in finance, business, or a related field. Proficiency with claims management systems, Excel, and actuarial software is commonly required, and certifications such as Associate of the Society of Actuaries (ASA) can be advantageous. Attention to detail, analytical thinking, and effective communication are crucial soft skills for interpreting complex data and liaising with clients or underwriters. These skills ensure accurate risk evaluation, effective claims management, and strong client relationships in the stop loss insurance sector.

What are the typical challenges stop loss analysts face when reviewing claims data and how can they address them?

Stop Loss Analysts often encounter challenges such as incomplete documentation, discrepancies in claims information, and the need to interpret complex medical or financial data. Successfully addressing these issues requires strong analytical skills, attention to detail, and effective communication with underwriters, claims adjusters, and healthcare providers. Proactively collaborating with other teams and leveraging specialized analytical tools can help streamline the process and ensure accurate risk assessment. Staying organized and maintaining up-to-date knowledge of policy changes also supports more efficient claim reviews.
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Stop Loss Analyst jobs near you
Infographic showing various Stop Loss Analyst job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 46% In-person, 9% Hybrid, and 45% Remote job distribution, with an average salary of $80,750 per year, or $38.8 per hour.

Medical Stop Loss Claims Auditor

EVOLUTION RISK PARTNERS, LLC

Evanston, IL

$75K - $85K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 17 days ago

Job description

Stop Loss Claims Auditor or Senior Stop Loss Claims Auditor

The Stop Loss Auditor is responsible for auditing and authorizing reimbursements of specific claims and effectively mitigate client medical stop loss claims and provide excellent customer service.

Experience/Qualifications:

  • 3-5+ years of experience in auditing medical Stop Loss Claims.
  • Audit stop loss claims and verify claims are paid in accordance with the Plan Document and reimbursable under the stop loss contract.  
  • Timely follow-up of pending claims to ensure additional information is received.
  • Recognize cost mitigation opportunities.
  • Interpret plan languages and stop loss contracts.
  • Familiar with the process of referring claims for over-authority review and approval to the carrier.
  • Efficient communication with both internal and external customers
  • Experience with auditing aggregate claims
  • Captive experience a plus
  • Ability to analyze claims and/or large claim management reports to post and/or adjust reserves.  

Skills/Abilities

  • 2-3 years medical claim processing or 3-5+ years Stop Loss Claims Auditing and reinsurance experience.
  • Bachelor’s degree a plus.  
  • Experience TPA Claims Processing and cost mitigation.
  • Proficient in Excel (for example: sorting, filtering, data, creating pivot tables.)
  • Ability to interpret and understand Plan Document wording and the application of provisions including eligibility.
  • Knowledge in COB, Medicare rules, CPT codes, REV codes, ICD-10 codes, HCPCS codes, J-codes
  • Excellent customer service, organizational with strong analytical skills
  • Detail/results-oriented
  • Ability to work independently with minimal supervision while meeting or exceeding established production and accuracy standards.
  • Ability to interpret and understand Stop Loss Contracts
  • Customer Service focused.
  • Excellent verbal and written communication skills

 What We Offer:

We're proud to offer a competitive salary, generous and flexible PTO & paid holidays, 401(k) with match, exclusive discount programs, health & wellness programs, and more. 

 Benefits:

  • Health insurance
  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Employee assistance program
  • Flexible spending account
  • Health savings account
  • Life insurance
  • Vision insurance

About Evolution Risk Partners, LLC

Evolution Risk Partners (ERP) is a full service Managing General Underwriter redefines partnership through a shared vision of success with employers and brokers. We provide organizations with customizable and innovative medical stop-loss solutions to ensure the financial stability of your self-funded medical program. Interested parties should visit www.evolutionrisk.com.