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Stop Loss Jobs (NOW HIRING)

Allied

Stop Loss Claims Specialist II-Specific

Chicago, IL · On-site +1

$24 - $26/hr

  • Medical

  • Dental

  • Vision

  • Life

  • PTO

POSITION SUMMARY The Stop Loss Claim Specialist II (Specific) is responsible for preparing and filing medical stop loss claims for reimbursement with stop loss carriers for individual stop loss ...

Curative HR LLC

Actuary- Stop Loss & ASO Pricing

Austin, TX · On-site

$150K - $190K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Stop loss is sold exclusively bundled with Curative's ASO/self-funded plan, so this role sits at the center of how the self-funded block is quoted, renewed, reserved, and reported. You will own the ...

New

Curative HR LLC

Actuary- Stop Loss & ASO Pricing

Austin, TX · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Stop loss is sold exclusively bundled with Curative's ASO/self-funded plan, so this role sits at the center of how the self-funded block is quoted, renewed, reserved, and reported. You will own the ...

New

Personify Health

Healthcare Stop Loss Specialist

Tempe, AZ · On-site

$22 - $25/hr

  • Medical

  • Dental

  • Retirement

  • PTO

Why This Role Matters Stop loss reimbursement doesn't happen automatically - it takes someone who knows how to move a claim from eligibility assessment to filed submission to recovered dollars ...

Personify Health

Healthcare Stop Loss Specialist

Tempe, AZ · On-site

$22 - $25/hr

  • Medical

  • Dental

  • Retirement

  • PTO

As a Stop Loss Specialist, you're the operational core of the filing process, managing spec claimants, tracking reimbursements, and keeping carriers and internal teams aligned. The accuracy and ...

Ryan Specialty

Stop Loss Data Modeler

$112K - $140K/yr

  • PTO

Build, maintain, and improve financial models and analytical tools supporting actuarial pricing, manual rating, and reporting for stop-loss, reinsurance, and captive programs * Translate the data ...

Acrisure

Senior Stop Loss Underwriter

Chicago, IL · On-site +1

$90K - $125K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Senior Stop Loss Underwriter is responsible for evaluating, pricing, and managing risk for employer-sponsored self-funded health plans. This role includes underwriting both new business and ...

Personify Health

Healthcare Stop Loss Specialist

Tempe, AZ · On-site

$22 - $25/hr

  • Medical

  • Dental

  • Retirement

  • PTO

As a Stop Loss Specialist, you're the operational core of the filing process, managing spec claimants, tracking reimbursements, and keeping carriers and internal teams aligned. The accuracy and ...

Acrisure

Senior Stop Loss Underwriter

Las Vegas, NV · On-site +1

$90K - $125K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Senior Stop Loss Underwriter is responsible for evaluating, pricing, and managing risk for employer-sponsored self-funded health plans. This role includes underwriting both new business and ...

Tokio Marine HCC

Vice President Sales (Stop Loss)

Kennesaw, GA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

TMHCC Stop Loss, a $2 Billion division within TMHCC, leads the way in providing medical stop loss insurance sold to employers. Medical Stop Loss provides an added layer of insurance protection to ...

Tmhcc

Vice President Sales (Stop Loss)

Kennesaw, GA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

TMHCC Stop Loss, a $2 Billion division within TMHCC, leads the way in providing medical stop loss insurance sold to employers. Medical Stop Loss provides an added layer of insurance protection to ...

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How much do stop loss jobs pay per hour?

As of Aug 14, 2026, the average hourly pay for stop loss in the United States is $22.38, according to ZipRecruiter salary data. Most workers in this role earn between $18.27 and $25.72 per hour, depending on experience, location, and employer.

What are some typical challenges faced by stop loss specialists in their day-to-day work?

Stop Loss specialists frequently encounter challenges such as balancing the need for thorough risk assessment with tight deadlines, interpreting complex claims data, and staying updated with changing regulations and market trends. They often manage multiple clients or policies simultaneously, requiring strong organizational and time-management skills. Additionally, collaborating with underwriting, claims, and broker teams is essential to ensure accurate and comprehensive coverage solutions. Developing effective communication strategies to explain policy details and recommendations to clients is key for success in this role.

What is a stop loss?

A Stop Loss job typically involves reviewing, analyzing, and managing stop-loss insurance policies, which help protect employers and insurers from catastrophic claims. Professionals in this role assess claims, set appropriate coverage limits, and work with underwriters, brokers, and policyholders to mitigate financial risk. They may also monitor trends in healthcare costs and claims data to adjust policies accordingly.

What are the key skills and qualifications needed to thrive in the stop loss position, and why are they important?

To thrive as a Stop Loss specialist, you need expertise in risk assessment, insurance policy analysis, and a strong understanding of healthcare or reinsurance principles, typically supported by a bachelor’s degree in finance, insurance, or a related field. Familiarity with industry platforms such as policy administration systems and strong proficiency in Excel or actuarial software are often required. Exceptional analytical thinking, attention to detail, and effective communication skills are highly valued for collaboration and client interactions. These abilities enable precise risk evaluation, thorough policy management, and the delivery of tailored solutions to clients and stakeholders.

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Stop Loss jobs near you
Infographic showing various Stop Loss job openings in the United States as of August 2026, with employment types broken down into 76% Full Time, 22% Part Time, 1% Temporary, and 1% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $46,560 per year, or $22.4 per hour.

Analyst, Stop Loss Accounting

BlueCross BlueShield of South Carolina

Columbia, SC • On-site

$46K - $61K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 22 days ago

BlueCross BlueShield of South Carolina rating

7.5

Company rating: 7.5 out of 10

Based on 69 frontline employees who took The Breakroom Quiz

221st of 307 rated insurance

Job description

Summary
Description
Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!
Position Purpose:
Responsible for submitting stop loss claim packets and responding to any requests for additional information. Additionally, the claims must be tracked and monitored. Complex analysis is performed and queries are generated to file and validate the claim submissions.
Logistics: BlueCross BlueShield of South Carolina.
Location: This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift scheduled during our normal business hours of 7:30AM-4:30PM. This role is located at 4101 Percival Road, Columbia, SC 29229.
What You'll Do:
  • Prepare and file 50% and 100% stop loss claim packets. Run queries, compile eligibility data and submit claim packet.
  • Audit stop loss positions by running queries and comparing to the accumulated claims in the billing system. Research variances, document discrepancies and make appropriate adjustments.
  • Respond to audit letters. Work with other areas including claims, marketing and managed care to obtain requested information.
  • Track claims packet filing and MGU responses. Log all submissions, audit letters receipts and responses in the tracking database/log.
  • Provide manual monitoring of special stop loss scenarios including carved out pharmacy. Ensure the member's stop loss positions are properly tracked and updated.
  • Perform complex reviews of claims data in situations where the stop loss system does not accurately accumulate stop loss positions. Create custom reports and spreadsheets based on customer inquiries.

To Qualify for This Position, You'll Need the Following:
  • Required Education: Bachelors in a job-related field
  • Degree Equivalency: 4 years job related work experience or Associate's and 2 years job related work experience
  • Required Experience: 3 years in accounting, auditing, billing, claims, membership, or finance.
  • Required Skills and Abilities: Ability to compile information, perform research and analyze data. Strong customer service and organizational skills.
  • Excellent verbal and written communication skills. Ability to take initiative and meet deadlines. Attention to detail.
  • Required Software and Other Tools: Microsoft Office including Access.

We Prefer That You have the Following:
  • Experience within a self-funded insurance programs.
  • Experience with AMMS claims processing system, experience with PFAB claims billing system, DB2 experience.

Our Comprehensive Benefits Package Includes the Following:
We offer our employees great benefits and rewards. You will be eligible to participate in our benefits program the first of the month following 28 days of employment.
  • Subsidized health plans, dental and vision coverage
  • 401k retirement savings plan with company match
  • Life Insurance
  • Paid Time Off (PTO)
  • On-site cafeterias and fitness centers in major locations
  • Education Assistance
  • Service Recognition

What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
What To Expect Next:
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.
We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.
If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information.
Some states have required notifications. Here's more information.

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BlueCross BlueShield of South Carolina logo

About BlueCross BlueShield of South Carolina

Sourced by ZipRecruiter

BlueCross BlueShield of South Carolina, headquartered in Columbia, SC, USA, is a major stakeholder in the country's healthcare sector. The company holds the distinction of being one of the largest health insurers in South Carolina. As an independent licensee of the BlueCross BlueShield Association, it offers an extensive range of health insurance products and services, focusing not just on medical coverage, but also on dental, vision, and other supplementary health options. The company was founded in 1946 and has since established itself as a trusted leader in the health sector, committed to affordability, accessibility, and customer service. Their mission is to ensure that all South Carolinians have access to high-quality healthcare and exemplify the core values of accountability, transparency, and commitment to customer satisfaction.

Industry

Insurance services

Company size

10,000+ Employees

Headquarters location

Columbia, SC, US

Year founded

1946

Social media

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