Finance Onboarding & Resolution Specialist

Health Plans Inc

About The Position

At HPI, we are a forward-thinking, national third-party administrator (TPA) specializing in self-funded health plan solutions. With over 44 years of industry expertise, our entrepreneurial spirit, flexible approach, and personalized service have empowered us to serve clients of all sizes across diverse industries. We deliver innovative strategies that maximize the value of every healthcare dollar. The self-funded health plan landscape is constantly evolving. At HPI, our partners benefit from having a TPA with the expertise, resources, and creativity to deliver customized plan solutions that help them win and retain more business. We excel at driving costs down and managing risk, while enhancing our clients’ employees’ health insurance experience. Our goal is to help members clearly understand their health plan and provide responsive service, enabling them to fully utilize their benefits and achieve greater health. Our commitment extends beyond our clients to our own employees. We foster a supportive and inclusive work environment where innovation thrives. By investing in our team’s growth and well-being, we ensure they are equipped to provide exceptional service. The Finance Onboarding & Resolution Specialist is responsible for managing end-to-end onboarding and issue resolution for funding and stop loss operations. The Specialist serves as a central liaison across internal teams, banking partners, and stop loss carriers, ensuring accurate setup, timely funding and reimbursement activity, and prompt resolution of escalations.

Requirements

Associate’s degree or equivalent work experience.
2+ years of experience in claims funding, stop loss administration, self-funded health plans, finance operations, or a related role within a TPA, carrier, or benefits administration environment.
Strong understanding of claims funding and stop loss workflows and financial controls.
Working knowledge of traditional stop loss, captive stop loss, and/or level‑funded programs.
Familiarity with banking processes, ACH funding, and reconciliation.
Proficiency with shared inbox management, tracking tools, and reporting.
Excellent organizational skills with the ability to manage multiple priorities and deadlines.
Strong written and verbal communication skills, including professional client correspondence.
High attention to detail and problem‑solving abilities.
Work within specified timeframe and meet deadlines.
Strong customer service orientation and ability to build relationships.
Risk awareness and escalation judgment
Demonstrated commitment to maintaining confidentiality and ethical practice.
Proficient in Microsoft Office, including Word, Excel, Outlook, and PowerPoint.

Nice To Haves

Experience supporting self‑funded health plans and employer‑funded claim payment models.
Experience in handling escalations or delinquent account management.
Experience working directly with stop loss carriers, brokers, and employer groups.
Familiarity with trend analysis, root cause analysis, or operational optimization initiatives.
Proficiency with claims administration systems (Javelina) and financial tracking tools (Ringmaster).
Experience with process improvement methodologies (Lean, Six Sigma, etc.).
Client‑focused problem solving
Process improvement mindset

Responsibilities

Lead end-to-end onboarding for new client groups covering claims funding and stop loss workflows.
Coordinate bank account setup, funding method selection, stop loss policy setup, carrier registration, and documentation collection
Partner with internal onboarding, implementation, finance, and client service teams to ensure a seamless transition to claims funding & stop loss workflow readiness.
Validate funding and stop loss configurations to prevent downstream errors
Monitor and manage weekly claims funding activity and reimbursement workflows
Proactively identify and address funding discrepancies, shortfalls, delays, or reimbursement issues.
Maintain ownership of outstanding claims pending advanced funding or reimbursement
Communicate with clients regarding past‑due funding, payment expectations, and potential claim impacts.
Document and escalate delinquency actions and outcomes in accordance with internal controls and audit requirements.
Serve as a subject matter resource for claims funding processes, timelines, and requirements.
Track, manage, prioritize, and resolve funding‑related and stop loss-related escalations
Ensure clear, professional, and timely communication with clients, brokers, banking partners, and internal stakeholders.
Collaborate with cross‑functional partners to research root causes and implement corrective actions.
Maintain accurate records of funding activity, stop loss activity, onboarding milestones, escalations, and resolutions.
Support internal audits and external audits
Contribute to the development and maintenance of standard operating procedures and job aids.
Perform additional tasks assigned.