Supplemental Health Appeals Associate

Job Summary

Seeking a motivated Supplemental Health Appeals Associate to work remotely on a full-time basis, responsible for conducting thorough appeal reviews and adjudicating decisions on Accident, Critical Illness, and Hospital Indemnity claims while managing a caseload and providing technical guidance to claims teams.

Key responsibilities

• Communicate with claimants and employers to ensure complete submission of necessary information for appeal review
• Analyze and adjudicate appeal decisions based on coverage, eligibility, and claims processes
• Collaborate with various stakeholders to resolve issues and ensure compliance with policies and procedures

Required qualifications

• 2+ years of experience in Supplemental Health Claims: Accident, Critical Illness, Hospital Indemnity
• 4-year Bachelor's degree (strongly preferred)
• Knowledge of claims processes and voluntary insurance products
• Ability to manage a caseload effectively
• Strong organizational skills with the ability to multi-task