Stop Loss Claims Administration

The Stop Loss Claims Administration subcontract for Harlingen Consolidated Independent School District involves managing the submission and adjudication of large loss claims for prime contractors on health plan projects. The selected provider is responsible for identifying claims that meet specific stop-loss thresholds, submitting necessary medical documentation through secure EDI, and overseeing the policy year run-out period. Deliverables include processed reimbursement claims and detailed monthly reconciliation reports to ensure accurate financial tracking. To qualify for this opportunity, providers must maintain HIPAA Compliance certification and SOC 2 Type II standards. The solicitation is categorized under NAICS code 524210 and is managed by Harlingen CISD in Texas. Interested parties must submit their responses by the deadline of October 19, 2026, to be considered for this administrative role.