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; 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. 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 the claim process. Contact claimants to notify them 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 they relate 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 identify inconsistencies or lags in claim information and utilize 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 the 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 or problems. Review, analyze, and meticulously code the following claim types: accident insurance, hospital indemnity & critical illness. Perform other duties as assigned. Qualifications High School Diploma or GED with 1 year of claims experience, or Bachelor’s degree with 1 year of insurance experience. Customer service experience. Organizational skills. Ability to handle multiple tasks at once. Knowledge of state regulations, statutes, and ERISA. Clear and concise verbal and written communication skills. PC proficiency in Word, Excel, PowerPoint, and 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). Detail‑oriented (preferred). 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. #J-18808-Ljbffr Chamberlain Advisors