About this role

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

Source listing: virtualvocations_main