Role Description

Reviews and evaluates Medicare Supplement claims to ensure accurate, timely, and thorough processing. Analyzes claim information to determine appropriate next steps while ensuring compliance with internal policies and regulatory requirements and delivering a high-quality customer experience.

Qualifications

• Current working knowledge within Hospital Indemnity and Hospital Indemnity product knowledge.
• Current working experience in Hospital Indemnity call center skills.
• Current experience within the Hospital Indemnity business area/acumen, with the ability to work independently and collaboratively while maintaining a positive, team-oriented approach.
• Strong analytical, organizational, and decision-making skills with close attention to detail.
• Excellent communication and customer service skills, with proficiency in common computer systems and the ability to manage complex or escalated situations.
• Promotes a culture of diversity and inclusion, values different ideas and opinions, and listens courageously, remaining curious in all that you do.
• Able to work remotely with access to a high-speed internet connection and located in the United States or Puerto Rico.

Requirements

• Evaluate and process complex Medicare Supplement claims by reviewing medical records, contract language, and supporting documentation to determine accurate payment or denial decisions.
• Analyze claim information, process transactions, and communicate with internal and external customers to obtain details, resolve inquiries, and finalize claims.
• Deliver high-quality customer service across phone, email, and written correspondence while resolving issues and creating clear explanations of claim determinations.
• Ensure compliance with company policies, regulatory requirements, and department standards while identifying potential referrals (e.g., legal, underwriting, special investigations).
• Contribute to team success through knowledge sharing, training support, process improvement initiatives, and maintaining strong relationships with customers and colleagues.

Benefits

• Hourly Wage: $21.25, plus annual bonus opportunity.
• 401(k) plan with a 2% company contribution and 6% company match.
• Work-life balance with vacation, personal time, and paid holidays.