Principal Health Claims Consultant - Medicare Supplement (Hiring Immediately)
USAA
Phoenix, AZ
29 days ago
$164,780 - $314,960
Job Description
Join USAA as a Principal Health Claims Consultant to provide expert medical consultation on Medicare Supplement claims. This role involves advising on morbidity risk, conducting research, and training investigators in a flexible work environment.
Key Responsibilities
Advise Medicare Supplement Claims Department
Review complicated medical histories and claims
Provide expert medical consultation
Conduct research on medical advancements
Serve as primary resource for medical risk assessment
Guide and train investigators
Participate in settlement negotiations
Collaborate with senior leaders on claims philosophy
Required Qualifications
Bachelor's degree OR 4 years of related experience
10 years of progressive health fraud experience
6 years as an RN, NP, or MD
4 years in medical coding and/or Medicare billing practices
Ability to interpret electrocardiograms and stress tests
Leading edge knowledge in medical theories and techniques
Experience in producing innovative solutions
Preferred Qualifications
US military experience or military spouse/domestic partner
4 years Medicare Claims Expertise
Expert advice on complicated medical records
Proficiency in medical coding
Regulatory experience with Medicare regulations
Investigation skills for healthcare fraud
Knowledge of Medicare Supplement claims operations
Ability to summarize and analyze medical records
Benefits & Perks
Comprehensive medical, dental, and vision plans401(k) and pensionLife insuranceParental benefits and adoption assistancePaid time off with paid holidays and volunteer hoursWellness programsCareer path planning and continuing education