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Stop Loss Claims Manager Jobs (NOW HIRING)

Brown & Brown Insurance

Trainer Stop Loss Claims

$80K - $100K/yr

Prior Team Lead or Management experience in stop loss claims to include experience with quality assurance. * Prior experience with industry repricing methodologies. (PPO, Wrap Networks, Reference ...

Brown & Brown, Inc.

Trainer Stop Loss Claims

$80K - $100K/yr

Prior Team Lead or Management experience in stop loss claims to include experience with quality assurance. * Prior experience with industry repricing methodologies. (PPO, Wrap Networks, Reference ...

Amwins

Amwins A&H- Claims Manager, Stop Loss

Seattle, WA · On-site

Manager, Stop Loss Claims (Remote) Amwins Accident & Health Underwriters, formerly known as Beacon Risk Strategies, is conducting a search looking for an experienced Manager, Stop loss Claims. Amwins ...

Ourhrconnect

$72K - $94K/yr

Communicate effectively with carriers, vendors, and management. Provide full claims service to both ... Develop new and review old stop loss claim forms. Assist with internal auditing of claims auditors ...

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Stop Loss Claims Manager information

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$35K

$87.9K

$139K

How much do stop loss claims manager jobs pay per year?

As of Aug 26, 2026, the average yearly pay for stop loss claims manager in the United States is $87,861.00, according to ZipRecruiter salary data. Most workers in this role earn between $68,000.00 and $105,000.00 per year, depending on experience, location, and employer.

What is a stop loss claims manager?

A Stop Loss Claims Manager is a professional responsible for overseeing and processing stop loss insurance claims for self-funded employer health plans. Their main duties include reviewing large or catastrophic medical claims, ensuring compliance with policy terms, and coordinating with third-party administrators and carriers. They help protect employers from excessive healthcare costs by ensuring claims are handled efficiently and accurately. Their expertise helps mitigate financial risk and ensures timely reimbursement for eligible claims.

What are the key skills and qualifications needed to thrive as a stop loss claims manager?

To thrive as a Stop Loss Claims Manager, you need expertise in stop loss insurance products, claims adjudication, and a solid understanding of health insurance regulations, typically supported by a bachelor's degree in a related field. Familiarity with claims management systems, data analysis tools, and industry-specific software such as Facets or QicLink is commonly required. Strong analytical thinking, attention to detail, and effective communication skills help you stand out in this role. These skills ensure accurate claims processing, regulatory compliance, and effective collaboration with clients and underwriters.

What are some common challenges faced by stop loss claims managers and how can they be effectively addressed?

Stop Loss Claims Managers often encounter challenges such as interpreting complex policy language, managing high volumes of claims, and ensuring timely, accurate adjudication. Effective communication with brokers, underwriters, and clients is crucial to resolve discrepancies and clarify coverage terms. Staying updated on regulatory changes and leveraging technology for claims processing can help streamline workflows and reduce errors. Developing strong analytical skills and fostering collaborative relationships within the claims and underwriting teams are also key to overcoming these challenges.
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Stop Loss Claims Manager jobs near you
Infographic showing various Stop Loss Claims Manager job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $87,861 per year, or $42.2 per hour.

Trainer Stop Loss Claims

Remote

Brown & Brown Insurance
See more jobs at Brown & Brown Insuranceexternal

$80K - $100K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 22 days ago

Job description

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers.

Brown & Brownis seeking aTrainer Stop Loss Claimsto join our growing team!

The incumbentis responsible forproviding training for newly hired Specific Stop Loss claims auditors and refresher training for all Specific Stop Loss claims auditors.

How You Will Contribute:

  • Develop a training curriculum with all necessary materials/documentation, covering all aspects of specific stop loss claims including, but not limited to logging claims, preparing working copies; systemline-itemdata entry, completing claim checklists and examining all claim details; pending and/or releasing payments, pend follow up and correspondence handling.

  • Establish an objective measuring tool for tracking trainee progress or lack thereof.

  • Train all new specific stop loss claim auditorstodeterminewhether they have successfully completed the training program and are ready to be placed in production with theirteam.

  • Serve as a subject matter expert for and assigned claims team andprovidetechnical guidance related to specific stop loss claims to the team.

  • 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 continuous process improvement opportunities are reviewed and implemented, asappropriate.

  • Contribute innovative ideas andassistwith the implementation of new processes.

Skills & Experience to be Successful:

  • 3-5 years of Specific Stop Loss Claim experience.

  • Prior Team Lead or Management experience in stop loss claims to include experience with quality assurance.

  • Prior experience with industry repricing methodologies. (PPO, Wrap Networks, Reference BasedPricing,etc.

  • Demonstratedproficiencyin Microsoft Office,includingMicrosoft Outlook.

  • Demonstrated strong analytical/critical thinkingskills;and detailoriented focus.

  • Strong written and verbal communication skills.

  • Ability to work independently with minimal supervision.

Preferred Qualifications:

  • Prior experience auditing aggregate stop loss claims.

  • History of successful Process Improvement initiatives.

  • Prior experience leading a team or managing processes.

Pay Range

$80,000 - $100,000 Annual

The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for the role.

Teammate Benefits & Total Well-Being

We go beyond standard benefits, focusing on the total well-being of our teammates, including:

  • Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance
  • Financial Benefits: ESPP; 401k; Student Loan Assistance; Tuition Reimbursement
  • Mental Health & Wellness: Free Mental Health &Enhanced Advocacy Services
  • Beyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts and more.

Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations.


Recruiting Vendor Disclosure Statement

Brown & Brown does not accept unsolicited resumes from external recruiters, recruitment vendors or employment agencies ("Recruiting Vendors"). Recruiting Vendors must have a valid written agreement and received prior written authorization from an authorized Brown & Brown representative before submitting candidates for any publicly posted role. Any unsolicited resumes submitted to Brown & Brown or its employees become the property of Brown & Brown, and no fees will be paid for such submissions. Additional information regarding this policy can be found on our careers page.

The Power To Be Yourself

As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, "The Power to Be Yourself".

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