Supplemental Claims Examiner

About the role

This role is responsible for adjudicating and processing supplemental insurance claims from intake through final payment. The position focuses on gathering and analyzing claim information, verifying eligibility, making accurate benefit decisions, and ensuring timely, precise payments. You’ll manage each claim end‑to‑end while delivering responsive, compassionate service to claimants, policyholders, and partners. The role also contributes to continuous improvement by bringing forward customer insights, identifying process gaps, and collaborating with teammates to enhance the overall claims experience.

Responsibilities

• Manage claim intake, review, and communication across both digital and paper channels.
• Verify eligibility, analyze coverage details, and adjudicate supplemental insurance claims.
• Complete the full payment process, including distribution, authorization, and lost‑check resolution.
• Apply claim management strategies to ensure accurate payments and appropriate financial outcomes.
• Participate in continuous improvement efforts by identifying issues, sharing customer insights, and supporting workflow enhancements.

Requirements

• Education: High School Diploma or equivalent.
• Experience: 2+ years of experience in supplemental claims processing
• Prior experience with medical billing or CPT coding.
• Strong ability to analyze information, interpret policy provisions, and make accurate claim decisions.
• Proficiency with Microsoft Office applications (Word, Outlook, Excel, PowerPoint).
• Experience collaborating with employers, brokers, TPAs, and other external partners.
• Familiarity with continuous improvement practices or customer‑experience‑focused workflows.

Key Behaviors

• Adaptability: Adjusts quickly to changing priorities and embraces new ways of working.
• Improvement Mindset: Seeks opportunities to streamline processes and enhance the customer experience.
• Driving Success: Takes initiative, pursues goals with persistence, and remains resilient when challenges arise.

Benefits

• A rich benefits package including medical, dental, vision and a 401(k) plan with matching company contributions
• An annual incentive bonus plan
• Generous paid time off including 11 holidays, 2 wellness days, and 8 volunteer hours annually — PTO increases with tenure
• A supportive, responsive management approach and opportunities for career growth and advancement
• Paid parental leave and adoption/surrogacy assistance
• An employee giving program that double matches your donations to eligible nonprofits and schools

Pay

Salary Range: 21.63 - 29.45