Finance Onboarding & Resolution Specialist
Job Description
Position: Finance Onboarding & Resolution Specialist
Department: Corporate Stop-Loss
Reports To: Manager, Quality & Process Optimization
FLSA Status: Non Exempt
About HPI
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.
Summary
The Finance Onboarding & Resolution Specialist is responsible for managing end-to-end onboarding and issue resolution for funding and stop loss operations. The Specialist serves as a central liaison across internal teams, banking partners, and stop loss carriers, ensuring accurate setup, timely funding and reimbursement activity, and prompt resolution of escalations.
Duties and Responsibilities (other duties may be assigned):
- Lead end-to-end onboarding for new client groups covering claims funding and stop loss workflows.
- Coordinate bank account setup, funding method selection, stop loss policy setup, carrier registration, and documentation collection
- Partner with internal onboarding, implementation, finance, and client service teams to ensure a seamless transition to claims funding & stop loss workflow readiness.
- Validate funding and stop loss configurations to prevent downstream errors
- Monitor and manage weekly claims funding activity and reimbursement workflows
- Proactively identify and address funding discrepancies, shortfalls, delays, or reimbursement issues.
- Maintain ownership of outstanding claims pending advanced funding or reimbursement
- Communicate with clients regarding past‑due funding, payment expectations, and potential claim impacts.
- Document and escalate delinquency actions and outcomes in accordance with internal controls and audit requirements.
- Serve as a subject matter resource for claims funding processes, timelines, and requirements.
- Track, manage, prioritize, and resolve funding‑related and stop loss-related escalations
- Ensure clear, professional, and timely communication with clients, brokers, banking partners, and internal stakeholders.
- Collaborate with cross‑functional partners to research root causes and implement corrective actions.
- Maintain accurate records of funding activity, stop loss activity, onboarding milestones, escalations, and resolutions.
- Support internal audits and external audits
- Contribute to the development and maintenance of standard operating procedures and job aids.
- Perform additional tasks assigned.
Minimum Education Requirements
- Associate’s degree or equivalent work experience.
Minimum Experience Requirements
- 2+ years of experience in claims funding, stop loss administration, self-funded health plans, finance operations, or a related role within a TPA, carrier, or benefits administration environment.
- Strong understanding of claims funding and stop loss workflows and financial controls.
- Working knowledge of traditional stop loss, captive stop loss, and/or level‑funded programs.
- Familiarity with banking processes, ACH funding, and reconciliation.
- Proficiency with shared inbox management, tracking tools, and reporting.
- Excellent organizational skills with the ability to manage multiple priorities and deadlines.
- Strong written and verbal communication skills, including professional client correspondence.
- High attention to detail and problem‑solving abilities.
- Work within specified timeframe and meet deadlines.
- Strong customer service orientation and ability to build relationships.
- Risk awareness and escalation judgment
- Demonstrated commitment to maintaining confidentiality and ethical practice.
Preferred Education Requirements:
Preferred Experience Requirements
- Experience supporting self‑funded health plans and employer‑funded claim payment models.
- Experience in handling escalations or delinquent account management.
- Experience working directly with stop loss carriers, brokers, and employer groups.
- Familiarity with trend analysis, root cause analysis, or operational optimization initiatives.
- Proficiency with claims administration systems (Javelina) and financial tracking tools (Ringmaster).
- Experience with process improvement methodologies (Lean, Six Sigma, etc.).
- Client‑focused problem solving
- Process improvement mindset
Computer Skills
Proficient in Microsoft Office, including Word, Excel, Outlook, and PowerPoint.
Reasonable Accommodation
Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the duties and responsibilities of the position.
Working Environment / Physical Demands
The work environment characteristics and physical demands described here are representative of those an employee may encounter while performing the duties of this job.
The noise level in the work environment is moderate. The employee may occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus. While performing the duties of this job, the employee is regularly required to sit, walk, speak, or hear. The employee is frequently required to use hands or feel or handle items as well as reach with hands and arms. The employee is occasionally required to stand.
Disclaimer
The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position.
*** Deadline to apply is 4/7/2026****
Health Plans Inc. is an EEO – M/F/D/V employer
