Talent.com
Stop Loss Examiner

Stop Loss Examiner

SymetraBellevue, Washington, United States
job_description.job_card.variable_hours_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

Symetra has an exciting opportunity to join our team as a Stop Loss Examiner !

About the role

The Claims Examiner is considered an entry level claims position within the stop loss department. Their expertise is considered foundational in the review, research, and resolution of specific stop loss claim situations. Duties include : the review and processing of claims; to include identifying and referring cases for cost-containment intervention and subrogation investigation, basic understanding of plan document review and policy provisions such as "experimental / investigational," "medically necessary", etc. This position has a fundamental understanding of the stop-loss claims adjudication process. Dollar authority from $0 - $75,000.

What you'll do in this role

  • Manage block of business, aligned with assigned RGM.
  • Audit and make reimbursement determinations of Stop Loss claims in accordance with the provisions of the Policyholder's Plan Document and Stop Loss Policy.
  • Adjudicate claim reimbursements within stated turnaround time goals.
  • Provide ad-hoc and year-end review of Policyholder reimbursements.
  • Maintain>

99% quality on claim procedures and financial accuracy which includes rudimentary documentation of pertinent claimants, plan, and policy information.

  • Support or back-up of peers, as needed. Production standards are within 4% - 6% of claim volume.
  • Maintain current pending claim files with consistent follow-up, documentation, and resolution or closure within defined timeframes. Interacts with administrator contacts and other internal / external resources to clearly communicate information needed to make reimbursement decision.
  • Provide prompt turnaround when requested information is received for reimbursement or denial.
  • Refine and increase knowledge of stop loss partners (other supporting departments), cost containment, best business practices, and providing and obtaining education in industry claim treads and cost containment solutions.
  • Claims examiners may be more reactive and transactional with internal and external communications or requests.
  • Special projects as identified by management.
  • What we offer you

    "Just do it! Even if you feel like you may not be 100% qualified, apply. Sometimes we see potential in others that they cannot see in themselves. You may be overqualified, or you may be the "something special" we are looking for to bring a unique, fresh approach to our company." - Ruby S., Associate EDX Analyst

    If you want to work for a company that is always considering its employees while working towards sustainable growth this is that company. Within Symetra, there is always innovation, empowerment, and growth opportunities, all while providing us with a great work / life balance and incredible benefits for a very reasonable cost!" - Cindy J. G., Sr. Product Owner

    "Symetra is truly a great place to work. The positive work climate, strong sense of team, and the resources available make it feel like one cohesive family. What stands out most to me is the company's deep commitment to diversity, equity, and inclusion-it's not just a statement, it's an active and ongoing priority that's felt throughout the organization." -Charlotte G., Sr. Underwriter - Consultant Stop Loss

    Benefits and Perks

    We don't take a "one-size-fits-all" approach when it comes to our employees. Our programs are designed to make your life better both at work and at home.

  • Flexible full-time or hybrid telecommuting arrangements
  • Plan for your future with our 401(k) plan and take advantage of immediate vesting and company matching up to 6%
  • Paid time away including vacation and sick time, flex days and ten paid holidays
  • Give back to your community and double your impact through our company matching
  • Want more details? Check out our Symetra Benefits Overview opens a pdf file
  • Compensation

    Hourly Salary Range : $23.92- $ 39.85 plus eligibility for annual bonus program

    Please review Symetra's Remote Network Minimum Requirements :

    As a remote-first organization committed to providing a positive experience for both employees and customers, Symetra has the following standards for employees' internet connection :

  • Minimum Internet Speed : 100 Mbps download and 20 Mbps upload, in alignment with the FCC's definition of "broadband."
  • Internet Type : Fiber, Cable (e.g., Comcast, Spectrum), or DSL.
  • Not Permissible : Satellite (e.g., Starlink), cellular broadband (hotspot or otherwise), any other wireless technology, or wired dial-up.
  • When applying to jobs at Symetra you'll be asked to test your internet speed and confirm that your internet connection meets or exceeds Symetra's standard as outlined above.

    Identity Verification

    Symetra is committed to fair and secure hiring practices. For all roles, candidates will be required (after the initial phone screen) to be on video for all interviews. Symetra will take affirmative steps at key points in the process to verify that a candidate is not seeking employment fraudulently, e.g. through use of a false identity.

    Failure to comply with verification procedures may result in :

  • Disqualification from the recruitment process
  • Withdrawal of a job offer
  • Termination of employment and other criminal and / or civil remedies, if fraud is discovered
  • Who you are

  • Strong analytical and contract interpretation skills.
  • Strong communication skills (oral and written).
  • Objective decision-making skill.
  • Ability to work with deadlines. Function effectively in a changing environment. Proficient in PC use.
  • High School diploma or equivalent experience required
  • We empowerinclusion.

    At Symetra,we aspire to be the most inclusive insurance company in the countrywe're building a place where every employee feels valued, respected, and has opportunities to contribute. Inclusion is about recognizing our assumptions, considering multiple perspectives, and removing barriers.

    We accept and celebrate diverse experiences, identities, and perspectives, because lifting each other up fuels thought and builds a stronger, more innovative company. We invite you to learn more about our effortshere.

    Creating a world where more people have access to financialfreedom.

    Symetra is a national financial services company dedicated to helping people achieve their financial goals and feel confident about the future. In our daily work, we're guided by the principles of Value, Transparency and Sustainability. This means we provide products and services people need at a competitive price, we communicate clearly and openly so people understand what they're buying, and we design products-and operate our company-to stand the test of time. We're committed to showing up for our communities, lifting up our employees, and standing up for diversity, equity and inclusion (DEI). Join our team and help us create a world where more people have access to financial freedom.

    For more information about our careers visit :

    careers

    Work Authorization

    Employer work visa sponsorship and support are not provided for this role. Applicants must be currently authorized to work in the United States at hire and must maintain authorization to work in the United States throughout their employment with our company.

    #LI-OR1

    #LI-Remote

    serp_jobs.job_alerts.create_a_job

    Examiner • Bellevue, Washington, United States

    Job_description.internal_linking.related_jobs
    • serp_jobs.job_card.promoted
    Travel CT Tech - $2528.84 / Week

    Travel CT Tech - $2528.84 / Week

    Ventura MedStaffPort Orchard, WA, US
    serp_jobs.job_card.full_time
    Ventura MedStaff is seeking an experienced CT Tech for an exciting Travel Allied job in Port Orchard, WA.Shift : 3x12 hr nights Start Date : 11 / 17 / 2025 Duration : 13 weeks Pay : $2528.Founded in 2018 a...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    Travel CT Tech - $2163.26 / Week

    Travel CT Tech - $2163.26 / Week

    AMN Healthcare AlliedPort Orchard, WA, US
    serp_jobs.job_card.full_time
    AMN Healthcare Allied is seeking an experienced CT Tech for an exciting Travel Allied job in Port Orchard, WA.Shift : 12 hr days Start Date : 11 / 17 / 2025 Duration : 13 weeks Pay : $2163.Job Description ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    Travel Echo Tech - $2,238 to $2,501 per week in Port Angeles, WA

    Travel Echo Tech - $2,238 to $2,501 per week in Port Angeles, WA

    AlliedTravelCareersTacoma, Washington, US
    serp_jobs.job_card.full_time
    AlliedTravelCareers is working with Prime Time Healthcare to find a qualified Echo Tech in Port Angeles, Washington, 98362!. Now Hiring : Allied Healthcare Ultrasound Echo - Port Angeles, WA.Contact ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    Insurance Loss Control Surveyor

    Insurance Loss Control Surveyor

    Davies Risk ServicesEverett, WA, US
    serp_jobs.job_card.full_time
    serp_jobs.filters_job_card.quick_apply
    Davies Risk Services is looking for independent contractors to perform insurance property inspections.This is a great opportunity for supplemental income or more. You determine your hours and volume...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Store Support

    Store Support

    Home Depot (Retail)Snohomish, WA, US
    serp_jobs.job_card.full_time +1
    Associates in Store Support positions are responsible for a variety of non-sales functions.This may include ensuring an outstanding customer order fulfillment experience, assisting customers in the...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Travel CT Technologist

    Travel CT Technologist

    Sharp Medical StaffingPort Townsend, WA, US
    serp_jobs.job_card.full_time
    Sharp Medical Staffing is seeking a travel CT Technologist for a travel job in Port Townsend, Washington.Job Description & Requirements. Start Date : ASAP (or 3-4 weeks from post date).Previous t...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Travel CT Tech - $2318.02 / Week

    Travel CT Tech - $2318.02 / Week

    AMN Healthcare AlliedPort Orchard, WA, US
    serp_jobs.job_card.full_time
    AMN Healthcare Allied is seeking an experienced CT Tech for an exciting Travel Allied job in Port Orchard, WA.Shift : 12 hr nights Start Date : 11 / 17 / 2025 Duration : 13 weeks Pay : $2318.Job Descriptio...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    Travel CT Tech - $2637.76 / Week

    Travel CT Tech - $2637.76 / Week

    Cynet HealthPort Orchard, WA, US
    serp_jobs.job_card.full_time
    Cynet Health is seeking an experienced CT Tech for an exciting Travel Allied job in Port Orchard, WA.Shift : 3x12 hr nights Start Date : 11 / 17 / 2025 Duration : 13 weeks Pay : $2637.Ranked #5 Best Travel...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Full-Time Loss Prevention Supervisor

    Full-Time Loss Prevention Supervisor

    Kohl'sSilverdale, WA, US
    serp_jobs.job_card.full_time +1
    As Loss Prevention Supervisor you will improve company profitability by executing company programs around external theft deterrence, internal investigations and operational shortage.You will increa...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    Travel CT Tech - $3294 / Week

    Travel CT Tech - $3294 / Week

    LancesoftTacoma, WA, US
    serp_jobs.job_card.full_time
    Lancesoft is seeking an experienced CT Tech for an exciting Travel Allied job in Tacoma, WA.Shift : 4x10 hr nights Start Date : 11 / 03 / 2025 Duration : 13 weeks Pay : $3294 / Week.LanceSoft’s mission is ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Travel Ultrasound Tech - $2,488 per week in Clarkston, WA

    Travel Ultrasound Tech - $2,488 per week in Clarkston, WA

    AlliedTravelCareersTacoma, Washington, US
    serp_jobs.job_card.full_time
    AlliedTravelCareers is working with Mindlance Health to find a qualified Ultrasound in Clarkston, Washington, 99403!.ID : 73066584 Shift : Mon- Fri Days 5 / 8s Description : Mon-Friday 4pm-midnight, wit...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_hour
    • serp_jobs.job_card.promoted
    Issaquah, WA - Field Inspector - Insurance Loss Control

    Issaquah, WA - Field Inspector - Insurance Loss Control

    H & S Loss Control InspectionsIssaquah, WA, US
    serp_jobs.job_card.full_time
    Qualified Field Inspectors For Insurance Loss Control.Pay : We pay a competitive standard flat fee per case based on customer as well as inspection type and complexity. The dominant standard flat fee...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Loss Prevention Clerk

    Loss Prevention Clerk

    Costco Wholesale CorporationGig Harbor, WA, US
    serp_jobs.job_card.full_time
    Position Summary : Protects company assets from internal and external theft.Observes and reports potential safety and security hazards. For additional information about pay ranges, click here.We offe...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Asset Protection Specialist

    Asset Protection Specialist

    Home Depot (Retail)Snohomish, WA, US
    serp_jobs.job_card.full_time +1
    The Asset Protection Specialist is primarily responsible for preventing financial loss caused by theft and fraud and supporting safety and environmental program compliance in their assigned store / m...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Store Protection Specialist

    Store Protection Specialist

    Ross StoresLakewood, WA, US
    serp_jobs.job_card.full_time
    Bring your talents to Ross, our leading off-price retail chain with over 2,200 stores, and a strong track record of success and growth. Our focus has always been bringing our customers a constant st...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Bremerton, WA - Field Inspector - Insurance Loss Control

    Bremerton, WA - Field Inspector - Insurance Loss Control

    H & S Loss Control InspectionsBremerton, WA, US
    serp_jobs.job_card.full_time
    Qualified Field Inspectors For Insurance Loss Control.Pay : We pay a competitive standard flat fee per case based on customer as well as inspection type and complexity. The dominant standard flat fee...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Lot Porter

    Lot Porter

    Camping World HoldingsSilverdale, WA, US
    serp_jobs.job_card.full_time +1
    Camping World is seeking a Lot Porter for our growing team.Camping World is looking for a Lot Porter to provide driving and support services as part of our first class service team What You'll Do : ....serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Error Resolution

    Error Resolution

    SanMarPreston, WA, US
    serp_jobs.job_card.full_time
    Salary Range : Youll earn between $21.Identify and troubleshoot discrepancies with shipments, inventory and orders and adjust inventory quantities. Maintain accurate department records.Understand and...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Medical Assistant Openings - Ear Nose and Throat

    Medical Assistant Openings - Ear Nose and Throat

    Providence Health and ServicesIssaquah, WA, US
    serp_jobs.job_card.full_time
    This is a combined posting for a Medical Assistant and Medical Assistant Registered WA.The requirements of each role are listed below under each associated title. Consideration for each role will be...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
    • serp_jobs.job_card.promoted
    Travel MedSurg Telemetry RN

    Travel MedSurg Telemetry RN

    CrossMedLakewood, WA, US
    serp_jobs.job_card.full_time
    CrossMed is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Lakewood, Washington.Job Description & Requirements. At CrossMed Healthcare Staffing, we aim to create last...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days