ZipRecruiter

Log In

2

Work From Home Stop Loss Rn Jobs (NOW HIRING)

Symetra

Examiner - Stop Loss

Bellevue, WA · On-site +1

$24.62 - $41.04/hr

Our programs are built to make your life better both at work and at home. * Flexible full-time or ... Disqualification from the recruitment process * Withdrawal of a job offer * Termination of ...

Sun Life Financial

Stop Loss & Health Claim Analyst

OR · On-site +1

$54K - $81K/yr

Knowledge of Stop Loss Claims and Stop Loss industry preferred * Demonstrated success in ... individuals from all backgrounds. Life is brighter when you work at Sun Life At Sun Life, we ...

Sun Life Financial

Stop Loss & Health Claim Analyst

OR · On-site +1

$54K - $81K/yr

Knowledge of Stop Loss Claims and Stop Loss industry preferred * Demonstrated success in ... individuals from all backgrounds. Life is brighter when you work at Sun Life At Sun Life, we ...

Symetra

Senior Stop Loss Underwriter - Remote

Bellevue, WA · On-site +1

$87K - $146K/yr

Our programs are designed to make your life better both at work and at home. * Flexible full-time ... Disqualification from the recruitment process * Withdrawal of a job offer * Termination of ...

next page

Showing results 1-20

People also search for

All JobsStop Loss Rn JobsWork From Home Stop Loss Rn Jobs

Work From Home Stop Loss Rn information

See salary details

$68K

$114.4K

$206K

How much do work from home stop loss rn jobs pay per year?

As of Jun 7, 2026, the average yearly pay for work from home 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 the difference between Work From Home Stop Loss Rn vs Work From Home Case Manager?

AspectWork From Home Stop Loss RnWork From Home Case Manager
CredentialsRN license, certifications in insurance or risk managementRN license, case management certification
Work EnvironmentHome-based, insurance and healthcare settingsHome-based, healthcare and insurance industries
Industry UsageInsurance companies, healthcare providersInsurance companies, healthcare organizations
Job FocusManaging stop loss insurance claims and riskCoordinating patient care and insurance processes

While both roles require RN licensure and healthcare knowledge, the Work From Home Stop Loss Rn focuses on managing insurance claims related to stop loss coverage, emphasizing risk assessment. In contrast, the Work From Home Case Manager concentrates on coordinating patient care and insurance processes. Both roles are home-based and serve the healthcare and insurance industries, but their primary responsibilities differ significantly.

What is a Work From Home Stop Loss RN?

A Work From Home Stop Loss RN is a registered nurse who works remotely, typically for insurance companies or third-party administrators, to review medical claims associated with stop loss insurance policies. Their main responsibility is to assess the medical necessity and appropriateness of claims that exceed certain thresholds, helping employers and insurers manage high-cost healthcare claims. These nurses use their clinical expertise to analyze medical records, communicate with providers, and ensure that claims are processed accurately and efficiently. Working from home allows them to perform these tasks virtually, often using secure digital platforms.

What are some common challenges faced by Work From Home Stop Loss RNs, and how can they be addressed?

Work From Home Stop Loss RNs often face challenges related to remote communication, maintaining up-to-date clinical knowledge, and managing a high volume of case reviews. Since collaboration is primarily virtual, it's important to develop strong written and verbal communication skills to effectively coordinate with physicians, case managers, and insurance teams. Staying current with clinical guidelines and leveraging digital tools for documentation and workflow management can help streamline responsibilities and ensure accurate decision-making. Building a structured daily routine and proactively seeking support from team leads or mentors can also help address feelings of isolation and ensure ongoing professional growth.

What are the key skills and qualifications needed to thrive as a Work From Home Stop Loss RN, and why are they important?

To thrive as a Work From Home Stop Loss RN, you need a current RN license, strong clinical assessment skills, and experience in utilization review or case management. Familiarity with health insurance systems, stop loss claims processes, and electronic medical record (EMR) platforms is typically required. Excellent attention to detail, critical thinking, and effective written communication are crucial soft skills for remote collaboration and accurate documentation. These abilities ensure accurate claim evaluations, regulatory compliance, and efficient coordination with insurers and healthcare providers.
More about Work From Home Stop Loss Rn jobs
What cities are hiring for Work From Home Stop Loss Rn jobs? Cities with the most Work From Home Stop Loss Rn job openings:
What states have the most Work From Home Stop Loss Rn jobs? States with the most job openings for Work From Home Stop Loss Rn jobs include:
What job categories do people searching Work From Home Stop Loss Rn jobs look for? The top searched job categories for Work From Home Stop Loss Rn jobs are:
Work From Home Stop Loss Rn jobs near you
Examiner - Stop Loss

Examiner - Stop Loss

Symetra

Bellevue, WA • On-site, Remote

$24.62 - $41.04/hr

Other

Retirement, PTO

Posted 4 days ago

Symetra rating

8.4

Company rating: 8.4 out of 10

Based on 17 frontline employees who took The Breakroom Quiz

87th of 260 rated insurance

Job description

Symetra offers a thrilling chance to become part of our team as an Examiner - Stop Loss!

About the role

Audit Individual Excess Loss claim submissions by analyzing excess loss policy provisions, employer plan document provisions, administrative agreements, and cost containment vendor agreements to ensure accurate claim reimbursements payable to the policyholder. Review potential claim notices and submissions for cost containment options and refer to Medical Risk Consultants or Cost Containment specialists.

What you will do

  • Review and decide on reimbursement of excess loss claims following the terms outlined in the Policyholder's Plan Document and Excess Loss Policy. Process claim reimbursements within established turnaround time targets. Sustain more than 99% accuracy in claim handling and financial correctness, including necessary documentation of relevant claimant, plan, and policy details.
  • Maintain current pending claims with consistent follow-up, documentation, and resolution or closure within defined timeframes. Interact with TPA contacts and other resources to clearly communicate information needed to make reimbursement decisions. Provide timely turnaround when requested information is received for reimbursement or denial.
  • Review advance notices of potential claims to identify and refer cases encouraged to become excess loss claims, needing MRC attention for renewal information or cost containment. Alert MRCs, RGMs, and Underwriters of possible catastrophic claims risk as well as unusual and complex claim issues.
  • Interact with internal and external customers responding to inquiries, handling appeals, facilitating claim resolutions, and providing and acquiring education in industry claim trends and cost containment solutions.
  • Undertake special projects as identified by management.

Why Work at Symetra

Here's what some of our employees share about why they choose to work at Symetra:

"I chose Symetra because I heard it was a pro-employee company-and it's absolutely true. The work environment is supportive, the people are great, and the benefits are generous. Symetra truly cares about its employees. The relaxed atmosphere and opportunities to learn and grow-both within your role and beyond-make it a great place to build your career." - Alicia L., Claims Examiner

What we offer you

Benefits and Perks

We don't take a "one-size-fits-all" approach when it comes to our employees. Our programs are built to make your life better both at work and at home.

  • Flexible full-time or hybrid telecommuting arrangements.
  • Plan for your future with our 401(k) plan and take advantage of immediate vesting and company matching up to 6%.
  • Paid time away including vacation and sick time, flex days and ten paid holidays.
  • Give back to your community and double your impact through our company matching.
  • Want more details? Check out our Symetra Benefits Overview.

Compensation

Hourly Range: $24.62 - $41.04 plus eligibility for annual bonus program.

Who You Are

  • High school diploma or equivalent work experience, college degree a plus.
  • 1-3 years of cumulative, relevant experience
  • Audit and bill review experience is a plus
  • Aggregate experience is a plus
  • Medical procedure terminology required
  • Proficiency with Excel
We empower inclusion
At Symetra, we aspire to be the most inclusive insurance company in the country. We're building a place where every employee feels valued, respected, and has opportunities to contribute.
Inclusion is about recognizing our assumptions, considering multiple perspective, and removing barriers. We accept and celebrate diverse experiences, identities, and perspectives, because lifting each other up fuels thought and builds a stronger, more innovative company. We invite you to learn more about our efforts here.
Creating a world where more people have access to financial freedom
Symetra is a national financial services company dedicated to helping people achieve their financial goals and feel confident about the future. In our daily work, we're guided by the principles of Value, Transparency and Sustainability. This means we provide products and services people need at a competitive price, we communicate clearly and openly so people understand what they're buying, and we design products--and operate our company--to stand the test of time. We're committed to showing up for our communities, lifting up our employees, and standing up for diversity, equity and inclusion (DEI). Join our team and help us create a world where more people have access to financial freedom.
For more information about our careers visit: https://symetra.eightfold.ai/careers
Work Authorization
Employer work visa sponsorship and support are not provided for this role. Applicants must be currently authorized to work in the United States at hire and must maintain authorization to work in the United States throughout their employment with our company.
Please review Symetra's Remote Network Minimum Requirements:
As a remote-first organization committed to providing a positive experience for both employees and customers, Symetra has the following standards for employees' internet connection:
  • Minimum Internet Speed:100 Mbps download and 20 Mbps upload, in alignment with the FCC's definition of "broadband."
  • Internet Type:Fiber, Cable (e.g., Comcast, Spectrum), or DSL.
  • Not Permissible:Satellite (e.g., Starlink), cellular broadband (hotspot or otherwise), any other wireless technology, or wired dial-up.
When applying to jobs at Symetra you'll be asked to test your internet speed and confirm that your internet connection meets or exceeds Symetra's standard as outlined above.
Identity Verification
Symetra is committed to fair and secure hiring practices. For all roles, candidates will be required (after the initial phone screen) to be on video for all interviews. Symetra will take affirmative steps at key points in the process to verify that a candidate is not seeking employment fraudulently, e.g. through use of a false identity.
Failure to comply with verification procedures may result in:
  • Disqualification from the recruitment process
  • Withdrawal of a job offer
  • Termination of employment and other criminal and/or civil remedies, if fraud is discovered

What Symetra employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply