Medical Specialist Principal - Life Company Medical Supplement Health Claims - Expertise in Medicare Claims Management (Hiring Immediately)
USAA
Phoenix, AZ
1 month ago
$164,780 - $314,960
Job Description
Join USAA as a Medical Specialist Principal, where you will play a vital role in Medicare Supplement Claims Management. You'll provide expert advice, review medical histories, and ensure claims accuracy, all while working in a flexible, supportive environment.
Key Responsibilities
Advise on morbidity and claims risk of health policies
Review complicated medical histories and testing results
Ensure claims payment accuracy per CMS guidelines
Conduct research on medical advancements and public health trends
Participate in settlement negotiations and provide medical consultations
Required Qualifications
Bachelor's degree or 4 years of related experience
10 years of progressive health fraud experience
6 years of experience as an RN, NP, or MD
4 years of experience in medical coding or Medicare billing
Ability to interpret electrocardiograms and stress test tracings
Demonstrated strategy development within the medical field
Preferred Qualifications
US military experience
Expertise in Medicare Supplement claims
Medical coding proficiency
Regulatory experience with Medicare state and federal regulations
Investigation skills in healthcare fraud
Benefits & Perks
Comprehensive medical, dental, and vision plans401(k) and pensionLife insuranceParental benefits and adoption assistancePaid time off with paid holidays and volunteer hoursCareer path planning and continuing education