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.

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• Adjudicate accident insurance, critical illness or specified disease, hospital indemnity, life product, and weekly income claims in accordance with established policies and procedures.
• Consistently follow documented workflow guidelines and departmental processes.
• Calculate benefits accurately using claim forms, medical information, plan certificates, contracts, and regulatory guidelines.
• Apply provisions related to misrepresentation, pre‑existing condition investigations, evidence of insurability reviews, benefit entitlement, financial accuracy, ERISA guidelines, MAR requirements, state regulations, and company liability as applicable.
• Proactively obtain complete and accurate information from groups, agencies, physicians, beneficiaries, and claimants to verify eligibility and resolve claim investigations.
• Maintain or exceed departmental productivity, quality, and service level standards.
• Provide professional, prompt, and accurate customer service via phone and written correspondence.
• Assume ownership of assigned claims and resolve customer issues and complaints in a timely manner.
• Investigate, research, and verify information to ensure claims are supported by sufficient documentation.
• Maintain required levels of confidentiality and data protection.
• Document claim activity and communications accurately in claim systems in accordance with company practices.
• Maintain working knowledge of policies, statutes, regulations, medical conditions, and departmental procedures.
• Identify recurring issues and recommend process improvements to management.
• Ensure all claim approvals, payments, and denials comply with departmental procedures and Unfair Claims Practice regulations.

• Bachelor’s degree or four years of equivalent business or related work experience.
• Typically two or more years of experience in insurance claims, benefits administration, or a related role.
• Strong decision‑making, problem‑solving, and research skills with the ability to analyze complex information.
• Proficiency with PC‑based applications including Microsoft Word, Excel, SharePoint, and Outlook.
• Knowledge of medical terminology.
• Strong customer service orientation with the ability to manage sensitive situations professionally.
• High attention to detail with the ability to maintain quality and accuracy in a fast‑paced environment.
• Clear, concise verbal and written communication skills.
• Completion of HIAA, LOMA, or ICA coursework. (Preferred)
• Aptitude for mathematics and critical thinking. (Preferred)
• Knowledge of state insurance regulations, statutes, and ERISA. (Preferred)
• Experience with claims or benefits systems such as ECM, STAR, Genelco or GIAS, Salesforce, UTS, or Benefits Manager. (Preferred)
• Experience handling critical illness, accident insurance, hospital indemnity, or short‑term disability claims. (Preferred)
• Ability to fluently speak and write Spanish. (Preferred)

Chamberlain Advisors is a veteran‑owned business that provides human capital solutions…