Higginbotham · 1 week ago
Senior Stop Loss Consultant
Fort Worth, TX
Full-time
Hybrid
Senior Level
7+ years expHigginbotham is seeking a Senior Stop Loss Consultant to be a foundational member of their stop-loss consulting practice. The role involves leading day-to-day execution, managing complex business operations, and contributing to team development and market positioning.
Insurance
Responsibilities
Lead or support the full stop-loss placement process: data collection, market submissions, quote analysis, and recommendation
Negotiate stop-loss contracts and renewals directly with carriers to ensure optimal pricing, terms, and coverage structures
Serve as a stop-loss lead on new business opportunities and client transitions from fully insured to self-funded arrangements
Oversee the stop-loss implementation process in coordination with TPAs and carrier partners, ensuring policies are issued accurately and on time
Review and reconcile contracts, disclosures, ASO provisions, and reimbursement terms for alignment and accuracy
Track all open implementation steps and ensure timely resolution of outstanding items
Monitor large claims activity and work closely with TPAs and carriers to support timely reimbursement submissions and payments
Escalate and resolve reimbursement delays, gray-area claims, and negotiated settlements with carriers on behalf of clients
Maintain a reimbursement and claims resolution tracker and report out internally on status and risks
Manage a portion of the stop-loss book, including strategic guidance on renewals, plan design, captives, lasers, and risk mitigation strategies
Support monthly and quarterly reviews with account teams and clients; prepare client-ready deliverables
Serve as a subject matter expert on stop-loss topics in client and prospect meetings alongside account executives or producers
Help direct and manage workflow for junior team members or peers as assigned, ensuring timely, accurate delivery of client work
Provide training, coaching, and support on stop-loss fundamentals and best practices
Collaborate with internal teams (account management, actuarial, analytics, clinical) to ensure integrated service delivery
Contribute to the development of standardized templates, reporting tools, and documentation procedures to improve efficiency and scale
Support ongoing refinement of carrier evaluation metrics and market intelligence
Participate in team planning sessions, business reviews, and feedback loops with leadership
Qualification
Required
Bachelor's degree in Business Administration, Risk Management, Healthcare Administration, or related field. Equivalent experience may be considered
Minimum of 7 years in employee benefits, with at least 5 years of direct stop-loss consulting, underwriting, or carrier negotiation experience
Experience with a mix of fully insured, level-funded, and self-funded plans across multiple funding structures (ASO, minimum premium, captives)
Familiarity with TPA models, ASO contract structures, and reimbursement mechanisms
Ability to interpret and explain stop-loss terms, underwriting decisions, and claim adjudication policies to internal and external stakeholders
Proficiency in Excel, PowerPoint, and internal reporting tools
Excellent critical thinking, communication, and interpersonal skills
Current state insurance license (or ability to obtain within 90 days of hire)
Preferred
Experience working with stop-loss platforms (e.g., Claros, Ringmaster) preferred
Benefits
Medical
Dental
Vision
Prescription drug coverage
401K
Equity prescription incentive plan
Multiple supplemental benefits for physical, emotional, and financial wellbeing
Company paid holidays
PTO
Employee Wellness Program
Company
Higginbotham
Higginbotham is a provider of insurance brokerage services to businesses and individuals.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Rusty Reid
Chairman, President & CEO
Andrew Reutter
Chief Financial Officer & Chief Operating Officer
Recent News
2025-12-16
2025-12-10
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