Nonstop Administration & Insurance Services

Claims Specialist

• Review and verify accuracy of MERP reimbursement claims and supporting documentation (e.g., EOBs, provider bills, receipts)
• Ensure claims meet plan eligibility and MERP-specific policy guidelines, including IRS-qualified expense criteria
• Make benefit determinations by applying plan rules, allowable expense definitions, and medical necessity standards
• Manage and maintain a caseload of 60+ client files, tracking each claim’s status and required follow-up
• Accurately enter and process claim data into the MERP claims management and payment systems
• Identify incomplete or non-allowable claims and request additional documentation as needed
• When necessary, communicate clearly and compassionately with members and providers regarding claim status, documentation requirements, and denials
• Coordinate closely with internal departments (e.g., Member Services, Development, Appeals etc.) to resolve issues and expedite claims
• Adjudicate claims in a timely and compliant manner, issuing approvals, denials, or payment adjustments as appropriate
• Initiate and monitor claim payment processes, ensuring timely check generation and mail distribution
• Maintain meticulous claim records for audit readiness and compliance with HIPAA and internal data privacy standards
• Support and uphold Nonstop’s commitment to quality member experience and efficient claims resolution

Account Executive

• Successfully renew contracts for all assigned channel clients
• Cultivate and nurture positive relationships between our clients and brokers
• Educate our client base (brokers and clients) on the Nonstop Health product
• Demonstrate expertise with both fully-insured and self-funded plan designs
• Review renewal and marketing (RFP) results and produce client-facing presentations (analytical comparisons)
• Maintain renewal project workflow by successfully collaborating with cross-functional teams and partners (internally and externally)
• Retain and cultivate a profitable book of business by owning the renewal process
• Provide timely updates to brokers and clients regarding upcoming initiatives, deadlines, topics of interest, and contracts/renewal packages
• Provide support and guidance on a variety of healthcare requirements and regulations
• Work with sales executives, implementation, and leadership to support the development of growth strategies

Client Executive

Product Manager

• Translate a defined product vision for Finance into a clear and actionable roadmap
• Collaborate with stakeholders and cross functional teams, to define strategies, solidify alignment, and drive outcomes
• Oversee the development of financial workflows, driving speed and success
• Work closely with engineering teams to define product requirements, prioritize initiatives, and drive agile development cycles
• Work with Finance to develop and track key performance indicators (KPIs) to measure the success and impact of solutions
• Partner with internal teams to communicate product value and execute strategies
• Act as a subject matter expert in the end-to-end finance workflow, providing guidance to internal teams and external partners

Claims Specialist

Client Executive

Senior Product Owner