📍 Remote – U.S. | 🕒 Full-time | 💼 Claims Operations
🧾 About the Role
Personify Health is seeking a detail-oriented Stop Loss Specialist to support claims tracking, contract interpretation, and reimbursement reconciliation. This role helps ensure timely communication with carriers and internal teams, all while managing large volumes of data with accuracy and clarity.
✅ Position Highlights
• Pay Range: $17–$23 per hour
• Employment Type: Full-time
• Location: Remote (U.S. only)
• Department: Claims Operations
• Benefits: Health, dental, vision, mental health coverage, PTO, and more
📋 What You’ll Own
• Monitor and document all stop-loss claim activity
• Track reimbursements, appeals, and carrier communications
• Reconcile and post monthly reimbursements
• Interpret stop-loss contracts, plan documents, and other reinsurance materials
• Prepare weekly, monthly, and special reports, including pharmacy-specific ones
• Maintain internal controls for audit-ready documentation
🎯 Must-Have Traits
• High school diploma or GED
• Strong Excel, Outlook, and Word skills
• Comfortable working independently under strict deadlines
• Excellent multitasking, communication, and problem-solving skills
• Bonus: Knowledge of CPT, HCPCS, ICD‑10 codes or previous experience in healthcare/claims processing
💻 Remote Requirements
• Reliable home setup and internet connection
• Self-motivated with strong time management
• Comfortable working in a virtual, deadline-driven environment
💡 Why It’s a Win for Remote Job Seekers
• Stable, benefits-eligible role in a growing health tech company
• Meaningful, behind-the-scenes work that supports real people’s healthcare needs
• Company committed to diversity, inclusion, and employee wellbeing
✍️ Call to Action
If you’re organized, analytical, and thrive on keeping things running smoothly, this role may be the perfect fit. Personify Health is ready to welcome someone who takes pride in behind-the-scenes excellence. Apply directly through their careers portal.