Job Summary

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

Key Responsibilities:

• Review and evaluate supplemental health insurance claims for eligibility, completeness, and accuracy
• Adjudicate claims using established guidelines and company policies
• Communicate claim decisions, payment details, and any additional requirements to policyholders and healthcare providers

Required Qualifications:

• Minimum of 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
• High school diploma or equivalent work experience