Senior Consultant, Supplemental Health Claims

A company is looking for a Senior Consultant, Supplemental Health Claims.

Key Responsibilities

Process and adjudicate supplemental health insurance claims for accuracy and compliance

Collaborate with the claims team to resolve complex or disputed claims and provide exceptional customer service

Perform quality assurance reviews and mentor other Claims Consultants

Required Qualifications

5+ years of experience in supplemental health insurance claims processing or medical billing

Strong knowledge of medical terminology, coding systems, and claim adjudication processes

Familiarity with healthcare industry regulations, including HIPAA and state insurance laws

Proficient in using claims management software and other computer applications

Ability to attain and maintain appropriate TPA licenses in accordance with the Claims Licensing Policy