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Stop Loss Rn Jobs (NOW HIRING)

Liberty Mutual

Senior Medical Specialist- Stop Loss/HMO

$110.30K - $176.80K/yr

Active, unrestricted RN license in state of residence. Experience : Minimum of 5 years of clinical ... Prior stop loss or HMO/PEI carrier experience required for senior position. Skills: * Ability to ...

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TEKsystems

Stop Loss Coordinator

Oakbrook Terrace, IL · Hybrid

$24 - $25/hr

Stop Loss Coordinator (Entry-Level) Our client, a growing organization within the insurance and ... Coordinate additional requirements, including nurse reviews when applicable * Assist the ...

New

Liberty Mutual

Senior Medical Specialist- Stop Loss/HMO

MA

$107.50K - $127.10K/yr

Active, unrestricted RN license in state of residence. Experience : Minimum of 5 years of clinical ... Prior stop loss or HMO/PEI carrier experience required for senior position. Skills: * Ability to ...

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How much do stop loss rn jobs pay per year?

As of May 31, 2026, the average yearly pay for stop loss rn in the United States is $114,374.00, according to ZipRecruiter salary data. Most workers in this role earn between $98,500.00 and $126,500.00 per year, depending on experience, location, and employer.

What is a Stop Loss RN job?

A Stop Loss RN is a registered nurse who reviews medical claims and patient records to evaluate the necessity, accuracy, and cost of healthcare services for insurance companies or employers. They help determine whether claims exceed stop-loss insurance thresholds, which protect insurers or self-funded employers from excessive financial risk. This role involves assessing medical necessity, verifying coding accuracy, and collaborating with case managers, providers, and insurance teams. Strong analytical skills and clinical expertise are essential for making informed decisions on high-cost claims.

What are the key skills and qualifications needed to thrive in the Stop Loss Rn position, and why are they important?

To thrive as a Stop Loss RN, you need in-depth clinical nursing experience, a strong understanding of insurance policies and claims, and RN licensure. Familiarity with medical claims adjudication systems, electronic health records, and utilization review platforms is typically required. Excellent communication, critical thinking, and attention to detail set top performers apart in this role. These skills are important to effectively review complex medical cases, ensure appropriate healthcare coverage, and collaborate with both providers and insurers.

What are the typical daily responsibilities of a Stop Loss RN?

As a Stop Loss RN, your typical day involves reviewing high-cost medical claims, verifying the medical necessity of treatments, and assessing policy compliance to determine insurance coverage. You’ll collaborate closely with clinical staff, insurance specialists, and sometimes directly with healthcare providers to gather relevant information and ensure accurate case evaluations. Many Stop Loss RNs also prepare detailed reports and participate in case conferences. This role often combines remote desk work with communications across multidisciplinary teams, creating a dynamic environment well-suited for nurses looking to leverage their clinical expertise in an insurance or administrative setting.
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Stop Loss Rn jobs near you
Infographic showing various Stop Loss Rn job openings in the United States as of May 2026, with employment types broken down into 8% As Needed, 52% Full Time, 31% Part Time, and 9% Contract. Highlights an 97% Physical, and 3% Remote job distribution, with an average salary of $114,374 per year, or $55 per hour.
Stop Loss Coordinator

Stop Loss Coordinator

BCS Financial Corporation

Villa Park, IL

Full-time

Posted 23 days ago

Job description

Position Overview
The Stop Loss Coordinator provides support to the Stop Loss Underwriting department. The role is responsible for the management of the stop loss proposal inbox, quote set-up, and manipulating electronic files for data entry. This position manages the quote activity process and ensures that quotes are released in a timely manner.
This position will report to the AVP, Accident & Health Underwriting
Essential Elements
  • Quote Management- Manage quote inbox by prioritizing requests, meeting quote turnaround times and answering all questions related to the quote
  • Customer Service- Troubleshoot and communicate effectively with external and internal partners to resolve quote requests issues and concerns
  • File Management- Set up both electronic and hard copy file for the Underwriter, review file for completeness and request additional data, setting up nurse reviews
  • Onboarding Support- Assist the Underwriting team with new and sold case business processing
  • Reporting- Assist with the preparation of monthly reports

Requirements
Education and Certifications
  • Associate's degree or commensurate experience preferred

Experience
  • 2 years of experience in the health insurance industry or an equivalent field preferred
  • Proficiency with computers and standard software applications such as Microsoft Office, including Excel and Word required

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