Stop Loss Analyst

Hilb Group

Stop Loss Analyst managing self-funded benefits claims, reimbursement tracking, and reporting for Hilb Group. Analyzing high-cost claims and financial exposure across client benefit plans.

Posted 8/5/2026full-timeCanton • Connecticut, Massachusetts, Rhode Island • 🇺🇸 United StatesJuniorMid-Level💰 $72,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in stop loss administration, claims analysis, and financial reporting, with a strong focus on data integrity and analytical problem-solving. Proficient in managing multiple deadlines and enhancing reporting workflows to support strategic initiatives.

Highest-signal resume keywords

Stop Loss AdministrationClaims AnalysisAdvanced Excel SkillsLife/Accident and Health Insurance Agent LicenseData Integrity Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AnalysisStop Loss AdministrationData ValidationTrend AnalysisFinancial ReportingReimbursement ProcessesAnomaly DetectionCost-Saving OpportunitiesEligibility AnalysisReporting Skills

Soft Skills

Analytical SkillsProblem-Solving SkillsOrganizational SkillsAttention to DetailCommunication Skills

Tools & Technologies

Microsoft Office SuiteAgency Management SystemsStop Loss Carrier PortalsTPA PortalsPBM Portals

Certifications & Qualifications

Life/Accident and Health Insurance Agent License

Industry Keywords

Self-Funded PlansStop Loss ArrangementsEmployee BenefitsCarrier OperationsHigh-Cost Claim Reporting

About the role

Key responsibilities & impact

Monitor and manage all stop loss reporting activity for assigned clients
Download and review reports from carrier, TPA, PBM, and stop loss carrier portals
Analyze medical, pharmacy, eligibility, and stop loss claim data for self-funded clients
Maintain stop loss tracking databases, reporting logs, and standardized analytics templates
Coordinate required documentation and reporting submissions to stop loss carriers within contract timelines
Follow up on pended or denied claims to ensure adjudication and reimbursement
Coordinate with stop loss carriers, TPAs, PBMs, and internal consultants on reimbursement tracking and claim resolution
Create and maintain client reporting, financial exhibits, and stop loss analytics
Produce monthly, quarterly, and annual stop loss reporting
Manage monthly claims dashboards for assigned clients
Review high-cost claimant activity and provide month-over-month updates on claim costs, diagnoses, treatment, prognosis, and future exposure
Validate data and proactively resolve discrepancies and reporting issues
Support renewal, marketing, and strategic consulting initiatives with large claim summaries and reimbursement analyses
Enhance stop loss monitoring workflows, reporting tools, and quality-control procedures
Contribute to advanced claims analytics, trend analysis, cost-driver and utilization insights
Build and maintain standardized dashboards and executive-level financial exhibits
Support employer and employee contribution modeling and benefit-plan financial analysis
Partner with internal teams to improve data integrity and streamline reporting
Contribute to ad hoc analytical projects, anomaly detection, performance monitoring, cost-saving opportunities, and coverage-gap identification

Requirements

What you’ll need

High school diploma required
Some college level coursework preferred
Must obtain and maintain active Life/Accident and Health Insurance Agent License
Two to five years of experience in employee benefits, stop loss administration, carrier operations, claims analysis, or related field preferred
Strong analytical and problem-solving skills
Advanced Excel and reporting skills
Excellent organizational and tracking abilities with strong attention to detail
Ability to manage multiple deadlines and prioritize time-sensitive issues
Excellent oral and written communication skills
Strong follow-through and escalation management skills
Experience working with stop loss carriers, TPAs, PBMs, or self-funded plans preferred
Understanding of large claim reporting and reimbursement processes preferred
Proficient in Microsoft Office Suite and Agency Management Systems
Working knowledge and understanding of self-funded and stop loss arrangements

Benefits

Comp & perks

Company Paid Life Insurance
Long-Term and Short-Term Disability
Medical, Dental, Vision and FSA/HSA plans
401(k) with company match
Additional voluntary benefits including Critical Illness, Accident Insurance, Hospital Indemnity and Supplemental Life Insurance
Legal and Identity Protection
Pet benefits
Generous PTO
Career and professional development
An awesome team of professionals!