Job DetailsJob Location: Allied Benefit Systems - CHICAGO, IL 60606Position Type: Full TimeSalary Range: $23.00 - $24.00 HourlyJob Category: Claims POSITION SUMMARY: The Stop Loss Claim Specialist is responsible for preparing and filing medical stop loss claims for reimbursement with stop loss carriers for aggregate coverage. Additional duties include following up with the various carriers to ensure reimbursements are received in time and in full. Further responsibilities include the appeals of denied and reduced claim reimbursements, along with retaining the appropriate documentation needed to support the reimbursement request. ESSENTIAL FUNCTIONS: Compile and submit claim reports and the necessary documentation to file a stop loss claim. Frequently monitor the status of claims assigned and follow up with stop loss carriers. Strong ability to answer questions and requests from stop loss carriers for additional information promptly and with thorough information in support of claim reimbursement. Communicate with other internal departments to resolve claim issues. Ability to manage time to file aggregate accommodation, level funded and/or final claim submissions per contract stipulations. Appeal the denials or reduction of reimbursements by the stop loss carrier. Responsible for auditing the aggregate positions, tracking the funding balance and updated reporting monthly Prepare both the year end and monthly accommodation aggregate claim filings upon reconciliation of the claim activity. Understand stop loss policy provisions, as well as group plan documentation in support of claim reimbursements. Ability to adapt to new concepts and systems. Other duties as assigned. EDUCATION: High School diploma or equivalent required. Some college or equivalent work experience preferred. EXPERIENCE AND SKILLS: 1-2 years of claims experience in a self-funded environment Have a thorough knowledge of Stop Loss terminologies, concepts, and catastrophic claim handling Ability to interpret Stop Loss contracts and Client summary Plan Descriptions (SPD). Stop loss filing experience preferred Accounting or Finance background a plus. Proficient with Microsoft Office Suite, specifically with Microsoft Excel. Strong analytical and problem-solving skills. Excellent verbal and written communication skills. Demonstrated elevated level of organizational skills and superior attention to detail. Excellent time management skills with a proven ability to meet deadlines. Demonstrated ability in developing and maintaining positive relationships with team members, internal departments, various brokers, reinsurance carriers, and clients. POSITION COMPETENCIES: Communication Customer Focus Accountability Functional/Technical Job Skills PHYSICAL DEMANDS: This is an office environment requiring extended sitting and computer work. WORK ENVIRONMENT: Remote Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive. The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend. Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.Qualifications

• Process claims, evaluating policy for coverage • Work with the insured, outside adjusters, agents and attorneys on the claim • Coordinate payment of claims • Prepare reports such as loss runs and monthly bordereau • Review policy to determine if loss is covered and hire attorney for coverage counsel if needed • Settle claims within settlement authority, where applicable • Attend mediations and negotiate settlements • Oversight of vendors for accuracy in reporting • Audit invoices for accuracy • Process incoming and outgoing claims and vendor payments • Maintain loss fund • Review and recommend policy wording changes • Perform claim status requests and updates • Prepare daily, weekly, and monthly reports • Travel for meetings with clients, mediations and underwriters (approximately 25% of time will be out of office)

Introduction At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it’s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives. It takes empathy, precision, and a strong sense of partnership—and that’s exactly what you’ll find here. We’re a team of fast-paced fixers, empathetic experts, and outcomes drivers — people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence. Here, you’ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you’re here, you’re part of something bigger. You’re part of a team that shows up, stands together, and leads with purpose. Overview Role specifics: - Jurisdictions: - Licenses: - Location: This role is eligible for fully remote work. How you'll make an impact - Apply claims management experience to execute decision-making to analyze claims exposure, plan the proper course of action, and appropriately resolve claims. - Interact extensively with various parties involved in the claim process to ensure effective communication and resolution. - Provide exceptional customer service to our claimants on behalf of our clients exhibiting empathy through each step of the claims process - Handle claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethics requirements. - Document and communicate claim activity timely and efficiently, supporting the outcome of the claim file. About You Ideal candidates for this position will have: - Claims Background: workers compensation lost time/indemnity - Jurisdictional Experience: - Active Adjusters' licenses: As a key member of our experienced Claims Adjuster team, you will: - Investigate, evaluate, and resolve complex workers compensation claims applying your analytical skills to make informed decisions and bring claims to resolution. - Work in partnership with our clients to deliver innovative solutions and enhance the claims management process - Think critically, solve problems, plan, and prioritize tasks to optimally serve clients and claimants Required Qualifications: - High School Diploma. - Minimum of 5 years related claims experience. - Appropriately licensed and/or certified in all states in which claims are being handled. - Knowledge of accepted industry standards and practices. - Computer experience with related claims and business software. Desired: - Bachelor's Degree #LI-KQ1 #LI-REMOTE Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you’ll get, depending on your job level these benefits may improve: - Medical/dental/vision plans, which start from day one! - Life and accident insurance - 401(K) and Roth options - Tax-advantaged accounts (HSA, FSA) - Educational expense reimbursement - Paid parental leave Other benefits include: - Digital mental health services (Talkspace) - Flexible work hours (availability varies by office and job function) - Training programs - Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing - Charitable matching gift program - And more... **The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process. We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as “protected characteristics”) by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.

Overview Join an amazing team that is consistently recognized for our achievements and culture, including our most recent Forbes award of being one of America's Best Midsize Employers for 2024! Training consists of 8 weeks of paid training. Monday through Friday from 8:00am-4:45pm PST. After training we offer a fixed schedule of 40 hours per week Monday through Friday from 8:00am-4:45pm PST. Geo-Salary Information An in-person interview may be required during the hiring process State specific pay scales for this role are as follows: $29.33 per hour (CA, NJ, NY, WA, HI, AK, MD, CT, RI, and MA) $26.92 per hour (NV, OR, AZ, CO, WY, TX, ND, MN, MO, IL, WI, FL, GA, MI, OH, VA, PA, DE, VT, NH, and ME). $24.52 per hour (UT, ID, MT, NM, SD, NE, KS, OK, IA, AR, LA, MS, AL, TN, KY, IN, SC, NC, and WV) This position is a work from home position that requires a dedicated workspace, free from distractions Responsibilities Position Overview If you’re passionate about helping people restore their lives when the unexpected happens, and providing high-quality customer experiences, then our Mercury Insurance Claims team could be the place for you! We offer dynamic and challenging opportunities to those who want to make a meaningful impact. With ongoing guidance and support, the Claims Specialist II takes the lead in guiding customers through the claims process. You will investigate and process claims for damage to vehicles and other property as well as moderate bodily injury claims. You will focus on accurate and efficient claims to prevent unnecessary expense to the Company and policyholders. You will provide excellent customer service to ensure our customers have a positive experience and feel valued and supported. At Mercury, we believe in nurturing growth, making time to have fun, and working together to make great things happen. Key Responsibilities: Customer Interaction and Claims Process Management: Review and explain coverage details and the claims process to customers. Set reserves for anticipated expenses and arrange vehicle inspections and rental authorizations. Address customer inquiries and concerns throughout the claim process to ensure satisfaction and retention. Investigation and Evidence Gathering: Utilize various communication methods (phone calls, emails, texts, letters) to obtain information from involved parties, including witnesses. Review law enforcement reports and seek out additional evidence (dash cam, surveillance video) to assess the facts of loss and determine liability. Risk Assessment and File Management: Identify and escalate high-risk files with significant indemnity exposure or suspected fraud to supervisors for further review or investigation. Bodily Injury Claims Management: Analyze medical records to evaluate, negotiate, and settle moderate bodily injury claims with legal counsel for represented claimants and unrepresented parties. Cross-Department Collaboration: Serve as the primary point of contact for customers, coordinating with other departments to ensure a smooth claims experience and complete customer satisfaction. Team Collaboration: Collaborate with a team to address the needs of shared customers when necessary. Qualifications - High school diploma or equivalent, Bachelor’s degree preferred - 6 months’ customer service experience in a high-volume work environment or equivalent combination of education and experience - 6-12 months’ claims adjusting experience, preferred - Prior experience working in a remote environment is a plus Physical Requirements Continuously (66%-100%):• Must be able to maintain a sedentary position for extended periods.• Must be able to communicate (electronically and telephonically) with team members, customers, and external parties.• Must be able to operate and type on a computer, laptop, and/or other Company-issued electronic device for extended periods of time.• Must be able to access and operate Company computer system, including preparing documents, entering data into computer system, and reading documents from a computer database or email system.Occasionally (Up to 33%):• Must be able to bend, stoop, reach, climb, and/or stand to access files, documents, and other equipment.• Must be able to grasp, open, and close drawers, filing cabinets, and other equipment. About the Company Why choose a career at Mercury? At Mercury, we have been guided by our purpose to help people reduce risk and overcome unexpected events for more than 60 years. We are one team with a common goal to help others. Everyone needs insurance and we can’t imagine a world without it. Our team will encourage you to grow, make time to have fun, and work together to make great things happen. We embrace the strengths and values of each team member. We believe in having diverse perspectives where everyone is included, to serve customers from all walks of life. We care about our people, and we mean it. We reward our talented professionals with a competitive salary, bonus potential, and a variety of benefits to help our team members reach their health, retirement, and professional goals. Learn more about us here: https://www.mercuryinsurance.com/about/careers Mercury Insurance is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other characteristic protected by federal, state, or local law. Perks and Benefits At Mercury, we seek a better way to serve our customers, own every interaction, do the right thing in every situation, and move quickly to deliver exceptional results. Join our team and make an impact today! We offer many great benefits, including: · Competitive compensation · Flexibility to work from anywhere in the United States for most positions · Paid time off (vacation time, sick time, paid Company holidays, volunteer hours) · Incentive bonus programs (potential for holiday bonus, referral bonus, and performance-based bonus) · Medical, dental, vision, life, and pet insurance · 401 (k) retirement savings plan with company match · Engaging work environment · Promotional opportunities · Education assistance · Professional and personal development opportunities · Company recognition program · Health and wellbeing resources, including free mental wellbeing therapy/coaching sessions, child and eldercare resources, and more. Pay Range USD $44,466.00 - USD $77,881.00 /Yr.