Supplemental Health Examiner

Job Title: Supplemental Health Examiner

Location: Lombard, IL; Richardson, TX; Amarillo, TX (Hybrid)

Duration & Type: Initial 3 to 6 Month Contract with potential for extension or conversion

Compensation & Benefits: Competitive W2 Hourly Rate ($22 - $22.75), Access to Healthcare and Dental Insurance Plan of Choice. (Benefit Plans can be requested at time of submission to client) Equipment provided, including a company-issued laptop.

Chamberlain Advisors is seeking a Supplemental Health Examiner to support the accurate and timely adjudication of supplemental health and life insurance claims within a high-volume claims environment. This role is responsible for analyzing, processing, and recommending approval or denial of accident, critical illness, hospital indemnity, life, and weekly income claims in accordance with established policies, regulatory requirements, and service standards. The ideal candidate brings strong analytical skills, attention to detail, and a customer-focused mindset while operating in a hybrid work environment with enterprise-grade tools and systems. Click Apply Now to join the Chamberlain experience!

What You Will Be Accountable For

• Evaluate and review claim forms to determine coverage amounts, eligibility, policy requirements and payment procedures.
• Coordinate with other parties to ensure seamless integration of claim process.
• Contact Claimants to notify by telephone or letter to verify questionable information submitted on claims.
• Create, review and edit member and benefit information including Self-Administered Billing, Self-Administered Billing-Web, Third Party Administrators, spouse and dependent coverages.
• Update party records and roles, benefit cases and benefit entitlements as it relates to claims.
• Complete Intake scripts and E-Forms.
• Maintain thorough knowledge of all policies, state statutes, regulations, ERISA, and departmental procedures to ensure proper dispositions of claims.
• Adhere to group special handling or preference in claim follow up activities
• Provide professional, prompt and accurate customer service to both internal and external customers.
• Adhere to quality, production, service and departmental guidelines to complete claims with diligent follow-ups.
• Proactively identifies inconsistencies or lag in claim information and utilizes effective approaches and resources to obtain clarification or verification.
• Communicate and interact effectively and professionally with co-workers, management, customers, etc.
• Maintain accurate Claim documentation of activities in claim file, systems and all communication, in a clear professional and approved format that is in accordance with company practices and procedures.
• Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
• Keep the superior informed of any pertinent developments or questionable claims which could have an adverse effect on the company
• Maintain complete confidentiality of company business.
• Maintain communication with management regarding development within areas of assigned responsibilities.
• Recommend changes to management to avoid recurring customer inquiries/problems.
• Review, analyze, and meticulously code the following claim types: Accident Insurance, Hospital Indemnity & Critical Illness
• Perform other duties as assigned
  
  

What Qualifications You Need

• High School Diploma OR GED and 1 year of claims experience OR Bachelor degree and 1 year of insurance experience.
• Customer Service experience.
• Organizational skills.
• Ability to handle multiples tasks at once.
• Knowledge of state regulations, statutes, and ERISA
• Clear and concise verbal and written communication skills.
• PC proficiency in Word, Excel, PowerPoint, Lotus Notes.
• Knowledge of ECM, STAR (Claim System), Genelco/GIAS, Salesforce, Benefits Manager, and Index Assist Tool. (Preferred)
• Aptitude for math and critical thinking skills. (Preferred)
• Knowledge of state regulations, statutes, and ERISA. (Preferred)
• Detailed oriented (Preferred)
  
  

Why Work with Chamberlain? Chamberlain Advisors is a veteran-owned business that provides human capital solutions across a wide range of industries and engagement types. Chamberlain candidates benefit from our unique hiring and interviewing process which has been designed to increase the likelihood that they will be successful in their job searches. This is achieved through our 5-step recruitment process, ensuring a top-of-the-line candidate experience. Find out what makes us different; apply to Chamberlain today.

Equal Employment Opportunity

Chamberlain Advisors provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, Chamberlain Advisors complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

Chamberlain Advisors expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Chamberlain Advisors' employees to perform their job duties may result in discipline up to and including discharge.