Supervisor, Stop-Loss Operations
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.
Requirements
- Associate’s degree or equivalent work experience
- Experience working in a TPA environment.
- 1+ years of supervisory or lead experience.
- Strong understanding of claims administration and stop-loss processes.
- Strong analytical, organizational, and problem-solving skills.
- Ability to manage multiple priorities in a fast-paced environment.
- Excellent verbal and written communication skills.
- Strong customer service orientation.
- Ability to work both independently and collaboratively.
- Ability to lead, train, and motivate staff.
- Commitment to confidentiality and ethical practice.
- Proficient in Microsoft Office, including Word, Excel, Outlook, and PowerPoint
Nice To Haves
- Experience in stop-loss insurance claims.
- Knowledge of Javelina, Ringmaster, or similar platforms.
- Working knowledge of medical terminology, eligibility rules (FMLA, COBRA, Medicare), and plan documents.
- Familiarity with continuous process improvement concepts.
Responsibilities
- Provide daily oversight of staff to ensure accurate and timely completion of stop-loss tasks and activities.
- Prioritize and distribute work assignments to meet departmental goals.
- Assist with department-level staffing, scheduling, quality control, and validation of staff performance.
- Support staff by answering questions and identifying training opportunities.
- Maintain and update standard operating procedures for stop-loss operations.
- Serve as a subject matter expert on stop-loss contracts, carrier requirements, and internal processes.
- Review and monitor groups for stop-loss submissions, including renewals and runout periods.
- Communicate with internal & external customers in regards to required documentation and deadlines.
- Participate in new business implementation meetings and stop-loss integration projects.
- Assist in researching and resolving client issues related to stop-loss transactions.
- Partner with management to identify process inefficiencies and propose improvements.
- Perform additional tasks as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
