Sr. Claims Specialist

At Lockton, we’re passionate about helping our people achieve their ultimate potential. Our people are curious, action-oriented and always striving to make ourselves and those around us better. We’re active listeners working to ensure understanding and problem solvers developing innovative solutions. If you can see yourself delivering excellent service to clients, giving back to our communities and being a part of our caring culture,
you belong here.

• Responsible for managing the full lifecycle of stop loss claim submissions with minimal oversight.
• Ensures accuracy, timeliness, and quality in the claims process, serving as a trusted partner to clients, carriers, and internal stakeholders.
• Acts as a subject matter resource within the team and can operate independently to resolve routine issues and ensure seamless execution.
• Manages end-to-end submission and tracking of stop loss claims with a focus on accuracy, speed, and completeness.
• Interprets and analyzes claim data, eligibility documents, EOBs, and carrier-specific requirements.
• Submits claims (specific and aggregate) to carriers and ensure proper follow-through until reimbursement is received.
• Identify and resolve discrepancies or delays directly with carrier contacts, requiring little to no escalation.
• Serve as a consistent point of contact for claims-related questions from internal account teams, Lockton Stop Loss associates, carrier and/or clients.
• Proactively communicates with carriers to troubleshoot processing issues and clarify submission requirements.
• Keeps stakeholders informed of claim statuses, outstanding documentation, and anticipated turnaround times.
• Maintains detailed and organized claim records, logs, and audit trails in accordance with Lockton standards.
• Supports reporting efforts related to claim volumes, reimbursement trends, and turnaround times.
• Ensures that all claim submissions meet quality control standards and internal documentation policies.
• Meets monthly Claims Exhibit deadlines for assigned book of business.
• Conducts a final policy year-end reconciliation for all policyholders, regardless of effective date.
• Communicates to Lockton Stop Loss associates once a final policy reconciliation has been completed.
• Monitors and organizes the Stop Loss and Stop Loss Reporting inboxes.
• Helps identify opportunities to enhance operational efficiency and client experience within the claims process.
• Assists claims analysts by sharing knowledge and answering questions, as needed.
• Supports onboarding of new analysts or claims team members by offering guidance and context

Preferred location:
Plano but open to remote

Lockton Companies is proud to provide everyone an equal opportunity to grow and advance. We are committed to an inclusive culture and environment where our people, clients and communities are treated with respect and dignity.

At Lockton, supporting diversity, equity and inclusion is ingrained in our values, and we believe that we are at our best when we fully embrace everyone. We strive to cultivate a caring culture that learns from, celebrates and thrives because of our breadth of differences. As such, we recognize that recruiting, developing and retaining people with diverse backgrounds and experiences is vital and enabling our people to thrive personally and professionally is critical to our long-term success.

Lockton is the largest privately held independent insurance brokerage in the world. Since 1966, our independence has allowed us to serve our clients, take care of our people and give back to our communities. As such, our 13,100+ Associates doing business in over 155 countries are empowered to do what’s right every day.

At Lockton, we believe in the power of all people. You belong at Lockton.

At Lockton, we empower you to be true to yourself in all that you do. Your success is our success, and we provide opportunities to help you grow and create a rewarding career path, however you envision it.

We are ready to meet you where you are today, and as your needs change over time. In addition to industry-leading health insurance, we offer additional options to support your overall health and wellbeing.