A&H Senior Claims Cost Containment Analyst
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At a glance
Requirements
Credentials this posting asks for.
Job overview
Westfield Specialty, Inc. is hiring an A&H Senior Claims Cost Containment Analyst. The Senior Claims Cost Containment Analyst supports the Accident & Health (A&H) team by serving as a forward-facing liaison to cost containment vendors and customers. This role provides hands-on support to stop loss and reinsurance claims operations, coordinating cost containment strategies, assisting in claims production, and helping manage claims inventory and volume to ensure timely, accurate, and compliant claim outcomes. The position partners closely with internal claims staff, underwriting, reinsurance partners, and external vendors.
Key focus areas include Assist with day-to-day activities of A&H reinsurance and stop loss claims function, Provide exceptional customer service through all interactions and communications, and Collaborate with management team on cost containment and claims operations.
Successful candidates bring Bachelor's Degree and 3-7 Years Stop Loss Claims Experience. Important skills include Healthcare Insurance Policies Knowledge, Healthcare Insurance Procedures Knowledge, Healthcare Insurance Regulations Knowledge, Stop Loss Policy Provisions Knowledge, Claims Adjudication, and Cost Containment Vendors Management.
Skills & qualifications
Skills
Qualifications
Full job description
Experience Required
None
Minimum Education Required
Bachelor Degree
Compensation
$15.92 / Hourly
Hours Per Week
40
Number Of Positions
1
Shift
First Shift (Day)
Job Description
Join Westfield Specialty's newest team!
Westfield Specialty's new A&H team has an opening for joining our expanding operation. As a key contributor on this highly experienced team, you'll help build a premier A&H reinsurance and insurance operation. This new team offers significant opportunities for career growth and development.
The Senior Stop Loss Claims & Cost Containment Analyst supports the Accident & Health (A&H) team by serving as a forward-facing liaison to cost containment vendors and customers while also providing hands-on support to stop loss and reinsurance claims operations. This role is responsible for coordinating cost containment strategies, assisting in claims production, and helping manage claims inventory and volume to ensure timely, accurate, and compliant claim outcomes.
The position partners closely with internal claims staff, underwriting, reinsurance partners, and external vendors to drive consistency, efficiency, and strong customer experience across the stop loss and reinsurance lifecycle.
Successful candidates will have a strong knowledge of healthcare insurance policies, procedures, and regulations.
What you will do:
Assist with the day-to-day activities of the A&H reinsurance and stop loss claims function, from first notice through resolution.
Provide exceptional customer service through all interactions and communications with internal and external business partners.
Collaborate with management team on cost containment and claims operations
Act as a primary point of contact for cost containment vendors (e.g., PPO networks, bill review, clinical management, specialty vendors).
Coordinate cost containment workflows to support stop loss and reinsurance claims outcomes.
Monitor vendor performance, turnaround times, and effectiveness; escalate issues as needed.
Assist in evaluating cost containment opportunities and process improvements.
Assist in reviewing, processing, and adjudicating stop loss and reinsurance claims in accordance with policy provisions and regulatory requirements.
Assist in developing and refining workflows, checklists, and best practices for stop loss claims and cost containment.
Contribute to training, knowledge sharing, and process documentation.
Support special projects related to claims operations, reinsurance reporting, or vendor initiatives.
Skills and experience:
Bachelor's degree or equivalent experience.
3-7 years of experience in stop loss claims, A&H claims, or reinsurance-related roles.
Strong working knowledge of stop loss policy provisions and claims adjudication.
Experience working with cost containment vendors and/or TPAs.
Ability to manage multiple priorities in a high-volume, deadline-driven environment.
Strong communication skills with the ability to interact confidently with internal and external partners.
Excellent written, verbal, and interpersonal communication skills.
Strong analytic, investigative, listening, and negotiation skills.
A desire to be part of a new and growing team.
Keen attention to detail.
Ability to work independently.
Demonstrated problem solving ability.
Why This Role Matters
This role plays a critical part in supporting stop loss and reinsurance profitability, customer satisfaction, and operational stability by bridging claims execution, vendor coordination, and customer engagement. The consultant helps ensure claims are handled efficiently while maximizing cost containment outcomes and supporting the broader A&H strategy.
About Westfield Specialty
Respected Leadership
Jack Kuhn, President of Westfield Specialty is a highly respected industry veteran who has successfully built and scaled insurance businesses multiple times in his career. He has been responsible for U.S. and Global Insurance portfolios of more than $6B in premium across the various executive leadership roles he's held within the insurance industry.
A Unique Opportunity
"We are excited about the opportunity to establish a broad and diverse portfolio of specialty business through deep relationships and expertise. We're building something that will stand the test of time." - Jack Kuhn
Why Join Westfield Specialty?
Because it is a unique opportunity to be a part of building a claims organization in a start-up environment without start-up risks. No legacy baggage. Work to live - we work hard, and we play hard. We are building a new claim organization and a new claim system, and we are looking for smart, team-oriented individuals to help us create a new platform. This is a great opportunity to leave your imprint on a program that will be built to last!
Excitement of a Start-Up with Stability
With a surplus of over $3 billion and an over 170-year history, Westfield combined their unprecedented financial strength, a stellar reputation, and ideal market conditions to the start-up opportunity that is Westfield Specialty.
Unique risks demand unique solutions and the talented team at Westfield Specialty relishes a challenge. We develop creative solutions to protect businesses and recover losses as well as drive growth for everyone in the value chain. Coverage for specialized risks requires creativity, and our team of experts has the knowledge and know-how that only comes from deep expertise. It's that robust combination of stability and boldness that makes Westfield stand above the rest. That's Westfield Specialty - where people make the difference!
This job description describes the general nature and level of work performed in this role. It is not intended to be an exhaustive list of all duties, skills, responsibilities, knowledge, etc. These may be subject to change and additional functions may be assigned as needed by management.
Westfield Specialty is proud to be an Equal Employment Opportunity employer. We celebrate diversity and do not discriminate based on race, religion, color, national origin, gender, sexual orientation, age, veteran status, disability status, or any other applicable characteristics protected by law.
#WSP
Westfield celebrates diversity and is committed to inclusion. All qualified applicants receive consideration for employment without regard to race, color, sex, religion, national origin, age, sexual orientation, gender identity, disability, or status as a protected veteran.
Place of Work
On-site
Requisition ID
11835
Job Type
Full Time
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