Med Supp Claims Analyst

Job Summary

Detail-oriented and customer-focused, the full-time Med Supp Claims Analyst will evaluate and adjudicate complex claims remotely, ensuring compliance with internal policies and regulatory requirements while delivering exceptional customer service.

Key responsibilities

• Evaluate and adjudicate complex claims by reviewing medical records and supporting documentation to make accurate benefit payment or denial decisions
• Resolve claim inquiries through phone, email, and written correspondence, clearly explaining claim decisions and providing compliant resolution options
• Document claim activity and process transactions while adhering to company policies and regulatory requirements, contributing to operational excellence

Required qualifications

• Demonstrated proficiency working within the Med Supp Claims department
• Strong analytical, organizational, and decision-making skills to manage competing priorities in a fast-paced environment
• Effective communication skills, both verbal and written, to resolve customer inquiries and provide exceptional service
• Proficiency in Microsoft Office and data entry, with the ability to work varied schedules and maintain consistent attendance
• Ability to work remotely with access to a high-speed internet connection, located in the United States or Puerto Rico