Stop Loss Operations Analyst

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee the financial and administrative functions that support the stop loss program.

• Manage premium receipts, lockbox and ACH transactions, ensuring premiums are applied to the correct groups and policies.

• Reconcile enrollment figures, anticipated premiums, and actual premiums received.

• Address issues related to shortages, overpayments, unapplied cash, overdue premiums, and other discrepancies.

• Collaborate with Finance and Accounts Payable to coordinate return premium, commission and override payments, claim payment activities, and other financial transactions.

• Conduct monthly premium reconciliations and assist with month-end closures, bordereaux, carrier reporting, and program financial reporting.

• Administer policy management following final underwriting approval, which includes sold-case requirements, policy and form selection, preparation, amendments, endorsements, and tracking of outstanding items.

• Review policy documents against approved underwriting terms and escalate any discrepancies prior to issuance.

• Facilitate policy issuance activities executed by Stop Loss Specialists.

• Maintain processes, quality controls, status reports, reconciliations, exception reports, controls, and audit documentation.

• Manage agency and producer licensing, carrier appointments, renewals, state-specific prerequisites, regulatory correspondence, and relevant documentation.

• Keep TPA and producer due diligence records and support approval processes.

• Assist with carrier, financial, and internal audits, resolving any identified issues.

• Create operational reports and identify ways to enhance accuracy, efficiency, transparency, controls, and cross-training.

• Coordinate workflows between Stop Loss Specialists and internal teams.

• Raise significant underwriting, financial, contractual, or compliance issues to leadership.

• Suggest improvements for processes, controls, and systems.

• Perform additional duties as assigned.

⛳️ Requirements

• A minimum of 3 years of experience in insurance operations, premium administration, accounting or reconciliation, policy administration, or a related domain.

• Familiarity with self-funded medical plans, employer stop loss terminology, insurance contracts, and operational workflows.

• Exceptional reconciliation and analytical capabilities concerning premium, enrollment, policy, and financial data.

• Capacity to interpret policy and underwriting terms and recognize discrepancies that need review.

• Experience in managing financial or administrative processes under defined controls, timelines, and documentation standards.

• Strong attention to detail and the ability to maintain accurate, comprehensive, audit-ready records.

• Excellent organizational and time-management skills.

• Proficient written and verbal communication skills, with the ability to work collaboratively with carriers, TPAs, producers, Finance, Underwriting, Claims, and internal teams.

• Proficiency in Microsoft Office, particularly Excel and Word.

• Willingness to learn about stop loss administration, underwriting, and reporting platforms.

• Ability to independently manage assigned operational tasks and appropriately escalate significant exceptions.

• Must be based in the US and comply with company policies, including HIPAA.

• Reliable internet connection is required.

• Ability to comply with security protocols, including VPN usage, secure passwords, and company-approved devices/software.

• A bachelor's degree in Accounting, Finance, Business, Insurance, or a related field is advantageous.

• Experience with employer stop loss, self-funded medical plans, premium administration, or policy issuance is a plus.

• Knowledge of carrier bordereaux, month-end reconciliation, insurance financial reporting, licensing, carrier appointments, producer records, policy preparation, endorsements, amendments, due diligence, audits, or relevant platforms is a plus.

🏝️ Benefits

• Competitive compensation aligned with experience and performance.

• Comprehensive benefits package with generous employer contributions.

• Flexible working arrangements, including remote options.

• 401k plan with a generous employer match and immediate vesting.

• Opportunities for personal and professional development.

• Family-friendly benefits, including paid leave for new family members.

• Company-wide philanthropic initiative, Valenz Communities Connection.

• Provision of necessary equipment.

• Medical, Dental, and Vision insurance coverage.

• Options for HSA, FSA, and DCFSA spending accounts.

• Flexible work environment.

• Generous Paid Time Off, encompassing vacation, sick leave, and paid holidays.

• Employee Assistance Program offering professional counseling, referrals, and additional services.

• Paid maternity and paternity leave.

• Pet insurance available.

• Employee discounts on phone plans, car rentals, and computers.

• Opportunities for community involvement, including paid time off for philanthropic activities.