Stop Loss Claims Specialist I-Specific

{
  "content_hash": "bfaf8648ce26ed72be04ed760c5f1c6c5b2631e1e5efd5a898109889715e3781",
  "source_hash": "3dcecdac24f51cd54ec178c9011bb1f198cbec704f7ccc553c82af59c2ff154a",
  "last_changed_at": "2026-05-31T19:05:28.503Z",
  "active_status": "active"
}

{
  "language": "en",
  "location": {
    "raw": "Allied Benefit Systems - CHICAGO, IL 60606; 200 WEST ADAMS ST, CHICAGO, IL, 60606, USA",
    "city": "CHICAGO",
    "region": "IL",
    "country": "United States",
    "is_remote": true,
    "confidence": 0.8
  },
  "salary_max": 24,
  "salary_min": 23,
  "inferred_at": "2026-06-06T20:18:38.846Z",
  "launch_scope": {
    "reason": "english_us_canada",
    "included": true,
    "language": "en",
    "location": {
      "raw": "Allied Benefit Systems - CHICAGO, IL 60606; 200 WEST ADAMS ST, CHICAGO, IL, 60606, USA",
      "city": "CHICAGO",
      "region": "IL",
      "country": "United States",
      "is_remote": true,
      "confidence": 0.8
    },
    "countries": [
      "United States"
    ]
  },
  "remote_policy": "remote",
  "salary_period": "hour",
  "workplace_type": "remote",
  "salary_currency": "USD"
}

{}

{
  "detail": {
    "city": "CHICAGO",
    "jobId": 186717,
    "level": "",
    "endDate": "",
    "legalId": 17,
    "isHotJob": false,
    "jobShift": "",
    "jobTitle": "Stop Loss Claims Specialist I-Specific",
    "location": "Allied Benefit Systems - CHICAGO, IL 60606",
    "startDate": "",
    "clientCode": "16672",
    "remoteType": "Fully Remote",
    "description": "<p><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><b><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">POSITION SUMMARY</span></span></b></span></span></span></p>\n\n<p><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">The Stop Loss Claim Specialist is responsible for preparing and filing medical stop loss claims for reimbursement with stop loss carriers for individual stop loss (specific) coverage.  Additional duties include following up with the various carriers to ensure reimbursements are received in time and in full.  Further responsibilities include the appeals of denied and reduced claim reimbursements, along with retaining the appropriate documentation needed to support the reimbursement request.</span></span></span></span></span></p>\n\n<p style=\"text-align:justify;\"> </p>\n\n<p><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><b><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">ESSENTIAL FUNCTIONS</span></span></b></span></span></span></p>\n\n<ul style=\"margin-bottom:11px;\">\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\">Compile and submit claim reports and the necessary documentation to file a stop loss claim.</span></span></span></span></li>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\">Frequently monitor the status of claims assigned and follow up with stop loss carriers.</span></span></span></span></li>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\">Strong ability to answer questions and requests from stop loss carriers for additional information promptly and with thorough information in support of claim reimbursement.</span></span></span></span></li>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\">Communicate with other internal departments to resolve claim issues.</span></span></span></span></li>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\"><span style=\"color:#2d2d2d;\">Prepare both the initial, subsequent, and year end claim filings upon reconciliation of the claim activity.</span></span></span></span></span></li>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\"><span style=\"color:#000000;\">Ability to manage time to file advanced funding, high dollar and renewal claim submissions per contract stipulations and department metrics.</span></span></span></span></span></li>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\">Appeal the denials or reduction of reimbursements by the stop loss carrier.</span></span></span></span></li>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\">Understand stop loss policy provisions, as well as group plan documentation in support of claim reimbursements.</span></span></span></span></li>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\">Ability to adapt to new concepts and systems.</span></span></span></span></li>\n\t<li style=\"margin-bottom:11px;margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\">Other duties as assigned.</span></span></span></span></li>\n</ul>\n\n<p><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><b><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">EDUCATION</span></span></b></span></span></span></p>\n\n<ul>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">High School diploma or equivalent required. </span></span></span></span></li>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Some college or equivalent work experience preferred.</span></span></span></span></li>\n</ul>\n\n<p> </p>\n\n<p><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><b><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">EXPERIENCE AND SKILLS</span></span></b></span></span></span></p>\n\n<ul>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><em><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">1 to 2 years of claims experience in a self funded environment</span></span></em></span></span></span></li>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\"><span style=\"color:#000000;\">Have a thorough knowledge of Stop Loss terminologies, concepts, and catastrophic claim handling</span></span></span></span></span></li>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\"><span style=\"color:#000000;\">Ability to interpret Stop Loss contracts and Client summary Plan Descriptions (SPD).</span></span></span></span></span></li>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><em><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Stop loss filing experience preferred</span></span></em></span></span></li>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Accounting or Finance background a plus.</span></span></span></span></span></li>\n</ul>\n\n<ul>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Proficient with Microsoft Office Suite, specifically with Microsoft Excel.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Strong analytical and problem solving skills.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Excellent verbal and written communication skills.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Demonstrated elevated level of organizational skills and superior attention to detail.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Excellent time management skills with a proven ability to meet deadlines.</span></span></span></span></span></li>\n\t<li><span style=\"font-size:12pt;\"><span style=\"color:#000000;\"><span><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Demonstrated ability in developing and maintaining positive relationships with team members, internal departments, various brokers, reinsurance carriers, and clients.</span></span></span></span></span></span></li>\n</ul>\n\n<p style=\"margin-left:48px;\"> </p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><b><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">POSITION COMPETENCIES</span></span></b></span></span></p>\n\n<ul>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\">Accountability</span></span></span></span></li>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:115%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\">Communication</span></span></span></span></li>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:115%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\">Customer Service Orientation</span></span></span></span></li>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:115%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\">Functional/Technical Skills</span></span></span></span></li>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:115%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\">Quality Focus</span></span></span></span></li>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:115%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\">Time and Task Management</span></span></span></span></li>\n</ul>\n\n<p> </p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><b><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">PHYSICAL DEMANDS</span></span></b> </span></span></p>\n\n<ul>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\">This is a standard desk role requiring extended sitting and computer work. </span></span></span></span></li>\n</ul>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"> </span></span></p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><b><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">WORK ENVIRONMENT</span></span></b></span></span></p>\n\n<ul>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\">Remote </span></span></span></span></li>\n</ul>\n\n<p> </p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:10.5pt;\"><span style=\"font-family:Arial, sans-serif;\">Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive</span></span><span style=\"font-size:10.5pt;\"><span style=\"font-family:Calibri, sans-serif;\">.</span></span></span></span></p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:10.5pt;\"><span style=\"font-family:Arial, sans-serif;\">The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.</span></span></span></span></p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:10.5pt;\"><span style=\"font-family:Arial, sans-serif;\">Compensation is not limited to base salary.  Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.</span></span></span></span></p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:10.5pt;\"><span style=\"font-family:Arial, sans-serif;\">Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time.  All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process.  It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.</span></span></span></span> </p>",
    "jobCategory": "Claims",
    "salaryRange": "$23.00 - $24.00 Hourly",
    "socialMedia": {
      "xLink": {
        "text": "Allied%2520Benefit%2520Systems%2520Job%2520Opportunity%2520Stop%2520Loss%2520Claims%2520Specialist%2520I-Specific"
      },
      "emailLink": {
        "subject": "Allied%20Benefit%20Systems%20Job%20Opportunity%20Stop%20Loss%20Claims%20Specialist%20I-Specific",
        "summary": "POSITION%20SUMMARY%0A%0AThe%20Stop%20Loss%20Claim%20Specialist%20is%20responsible%20for%20preparing%20and%20filing%20medical%20stop%20loss%20claims%20for%20reimbursement%20with%20stop%20loss%20carriers%20for%20individual%20stop%20loss%20%28specific%29%20coverage.%C2%20Additional%20duties%20include%20following%20up%20with%20the%20various%20carriers%20to%20ensure%20reimbursements%20are%20received%20in%20time%20and%20in%20full.%C2%20Further%20responsibilities%20include%20the%20appeals%20of%20denied%20and%20reduced%20claim%20reimbursements%2C%20along%20with%20retaining%20the%20appropriate%20documentation%20needed%20to%20support%20the%20reimbursement%20request.%0A%0A%C2%0A%0AESSENTIAL%20FUNCTIONS%0A%0A%0A%09Compile%20and%20submit%20claim%20reports%20and%20the%20necessary%20documentation%20to%20file%20a%20stop%20loss%20claim.%0A%09Frequently%20monitor%20the%20status%20of%20claims%20assigned%20and%20follow%20up%20with%20stop%20loss%20carriers.%0A%09Strong%20ability%20to%20answer%20questions%20and%20requests%20from%20stop%20loss%20carriers%20for%20additional%20information%20promptly%20and%20with%20thorough%20information%20in%20support%20of%20claim%20reimbursement.%0A%09Communicate%20with%20other%20internal%20departments%20to%20resolve%20claim%20issues.%0A%09Prepare%20both%20the%20initial%2C%20subsequent%2C%20and%20year%20end%20claim..."
      },
      "facebookLink": {
        "redirectUri": "",
        "facebookAppId": "773759036043100"
      },
      "linkedInLink": {}
    },
    "isQuickApply": false,
    "positionType": "Full Time",
    "countryPaidIn": "",
    "googleJobJson": "{\"@context\":\"https://schema.org/\",\"@type\":\"JobPosting\",\"title\":\"Stop Loss Claims Specialist I-Specific\",\"identifier\":\"J16672186717\",\"url\":\"https://www.paycomonline.net/v4/ats/web.php/portal/518A90CE68B712867516B5A3986512DA/jobs/186717\",\"image\":\"https://www.paycomonline.net/v4/ats/web.php/application/style/logo?clientkey=518A90CE68B712867516B5A3986512DA\",\"baseSalary\":{\"@type\":\"MonetaryAmount\",\"currency\":\"USD\",\"value\":{\"@type\":\"QuantitativeValue\",\"minValue\":23,\"maxValue\":24,\"unitText\":\"\"}},\"datePosted\":\"2026-05-29\",\"description\":\"Job DetailsJob Location: Allied Benefit Systems - CHICAGO, IL 60606Position Type: Full TimeSalary Range: $23.00 - $24.00 HourlyJob Category: ClaimsPOSITION SUMMARY\\n\\nThe Stop Loss Claim Specialist is responsible for preparing and filing medical stop loss claims for reimbursement with stop loss carriers for individual stop loss (specific) coverage.  Additional duties include following up with the various carriers to ensure reimbursements are received in time and in full.  Further responsibilities include the appeals of denied and reduced claim reimbursements, along with retaining the appropriate documentation needed to support the reimbursement request.\\n\\n \\n\\nESSENTIAL FUNCTIONS\\n\\n\\n\\tCompile and submit claim reports and the necessary documentation to file a stop loss claim.\\n\\tFrequently monitor the status of claims assigned and follow up with stop loss carriers.\\n\\tStrong ability to answer questions and requests from stop loss carriers for additional information promptly and with thorough information in support of claim reimbursement.\\n\\tCommunicate with other internal departments to resolve claim issues.\\n\\tPrepare both the initial, subsequent, and year end claim filings upon reconciliation of the claim activity.\\n\\tAbility to manage time to file advanced funding, high dollar and renewal claim submissions per contract stipulations and department metrics.\\n\\tAppeal the denials or reduction of reimbursements by the stop loss carrier.\\n\\tUnderstand stop loss policy provisions, as well as group plan documentation in support of claim reimbursements.\\n\\tAbility to adapt to new concepts and systems.\\n\\tOther duties as assigned.\\n\\n\\nEDUCATION\\n\\n\\n\\tHigh School diploma or equivalent required. \\n\\tSome college or equivalent work experience preferred.\\n\\n\\n \\n\\nEXPERIENCE AND SKILLS\\n\\n\\n\\t1 to 2 years of claims experience in a self funded environment\\n\\tHave a thorough knowledge of Stop Loss terminologies, concepts, and catastrophic claim handling\\n\\tAbility to interpret Stop Loss contracts and Client summary Plan Descriptions (SPD).\\n\\tStop loss filing experience preferred\\n\\tAccounting or Finance background a plus.\\n\\n\\n\\n\\tProficient with Microsoft Office Suite, specifically with Microsoft Excel.\\n\\tStrong analytical and problem solving skills.\\n\\tExcellent verbal and written communication skills.\\n\\tDemonstrated elevated level of organizational skills and superior attention to detail.\\n\\tExcellent time management skills with a proven ability to meet deadlines.\\n\\tDemonstrated ability in developing and maintaining positive relationships with team members, internal departments, various brokers, reinsurance carriers, and clients.\\n\\n\\n \\n\\nPOSITION COMPETENCIES\\n\\n\\n\\tAccountability\\n\\tCommunication\\n\\tCustomer Service Orientation\\n\\tFunctional/Technical Skills\\n\\tQuality Focus\\n\\tTime and Task Management\\n\\n\\n \\n\\nPHYSICAL DEMANDS \\n\\n\\n\\tThis is a standard desk role requiring extended sitting and computer work. \\n\\n\\n \\n\\nWORK ENVIRONMENT\\n\\n\\n\\tRemote \\n\\n\\n \\n\\nHere at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.\\n\\nThe company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.\\n\\nCompensation is not limited to base salary.  Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.\\n\\nAllied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time.  All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process.  It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role. Qualifications\",\"responsibilities\":\"POSITION SUMMARY\\n\\nThe Stop Loss Claim Specialist is responsible for preparing and filing medical stop loss claims for reimbursement with stop loss carriers for individual stop loss (specific) coverage.  Additional duties include following up with the various carriers to ensure reimbursements are received in time and in full.  Further responsibilities include the appeals of denied and reduced claim reimbursements, along with retaining the appropriate documentation needed to support the reimbursement request.\\n\\n \\n\\nESSENTIAL FUNCTIONS\\n\\n\\n\\tCompile and submit claim reports and the necessary documentation to file a stop loss claim.\\n\\tFrequently monitor the status of claims assigned and follow up with stop loss carriers.\\n\\tStrong ability to answer questions and requests from stop loss carriers for additional information promptly and with thorough information in support of claim reimbursement.\\n\\tCommunicate with other internal departments to resolve claim issues.\\n\\tPrepare both the initial, subsequent, and year end claim filings upon reconciliation of the claim activity.\\n\\tAbility to manage time to file advanced funding, high dollar and renewal claim submissions per contract stipulations and department metrics.\\n\\tAppeal the denials or reduction of reimbursements by the stop loss carrier.\\n\\tUnderstand stop loss policy provisions, as well as group plan documentation in support of claim reimbursements.\\n\\tAbility to adapt to new concepts and systems.\\n\\tOther duties as assigned.\\n\\n\\nEDUCATION\\n\\n\\n\\tHigh School diploma or equivalent required. \\n\\tSome college or equivalent work experience preferred.\\n\\n\\n \\n\\nEXPERIENCE AND SKILLS\\n\\n\\n\\t1 to 2 years of claims experience in a self funded environment\\n\\tHave a thorough knowledge of Stop Loss terminologies, concepts, and catastrophic claim handling\\n\\tAbility to interpret Stop Loss contracts and Client summary Plan Descriptions (SPD).\\n\\tStop loss filing experience preferred\\n\\tAccounting or Finance background a plus.\\n\\n\\n\\n\\tProficient with Microsoft Office Suite, specifically with Microsoft Excel.\\n\\tStrong analytical and problem solving skills.\\n\\tExcellent verbal and written communication skills.\\n\\tDemonstrated elevated level of organizational skills and superior attention to detail.\\n\\tExcellent time management skills with a proven ability to meet deadlines.\\n\\tDemonstrated ability in developing and maintaining positive relationships with team members, internal departments, various brokers, reinsurance carriers, and clients.\\n\\n\\n \\n\\nPOSITION COMPETENCIES\\n\\n\\n\\tAccountability\\n\\tCommunication\\n\\tCustomer Service Orientation\\n\\tFunctional/Technical Skills\\n\\tQuality Focus\\n\\tTime and Task Management\\n\\n\\n \\n\\nPHYSICAL DEMANDS \\n\\n\\n\\tThis is a standard desk role requiring extended sitting and computer work. \\n\\n\\n \\n\\nWORK ENVIRONMENT\\n\\n\\n\\tRemote \\n\\n\\n \\n\\nHere at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.\\n\\nThe company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.\\n\\nCompensation is not limited to base salary.  Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.\\n\\nAllied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time.  All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process.  It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role. \",\"employmentType\":\"FULL_TIME\",\"hiringOrganization\":{\"@type\":\"Organization\",\"name\":\"Allied Benefit Systems\",\"logo\":\"https://www.paycomonline.net/v4/ats/web.php/application/style/logo?clientkey=518A90CE68B712867516B5A3986512DA\"},\"jobLocation\":{\"@type\":\"Place\",\"address\":{\"streetAddress\":\"200 WEST ADAMS ST\",\"addressLocality\":\"CHICAGO\",\"addressRegion\":\"IL\",\"postalCode\":60606,\"addressCountry\":\"USA\"}},\"industry\":\"Claims\",\"validThrough\":\"-0001-11-30\"}",
    "applyAvailable": true,
    "educationLevel": "",
    "qualifications": "",
    "descriptionTitle": "Description",
    "travelPercentage": "",
    "jobYoutubeVideoId": "",
    "legalRevisionDate": {
      "date": "2026-01-15T10:45:37.000Z",
      "timezone": "America/Chicago",
      "timezone_type": 3
    },
    "secondaryLocations": [],
    "primaryPhoneCountry": "US",
    "primaryPhoneEnabled": true,
    "qualificationsTitle": "Qualifications",
    "primaryPhoneRequired": true,
    "primaryPhoneNumberDoesNotExist": false
  },
  "preview": {
    "jobId": 186717,
    "isHotJob": false,
    "jobTitle": "Stop Loss Claims Specialist I-Specific",
    "postedOn": "",
    "locations": "Allied Benefit Systems - CHICAGO, IL 60606",
    "remoteType": "Fully Remote",
    "description": "POSITION SUMMARY\n\nThe Stop Loss Claim Specialist is responsible for preparing and filing medical stop loss claims for reimbursement with stop loss car...",
    "positionType": "Full Time"
  },
  "detail_meta": {
    "url": "https://portal-applicant-tracking.us-cent.paycomonline.net/api/ats/job-postings/186717",
    "http_status": 200,
    "content_type": "application/json",
    "response_bytes": 35410
  },
  "detail_errors": []
}