Supplemental Health Claims Associate
Job Description
Location: Lombard, IL 60148 (Hybrid: 3 Days In-Office / 2 Days Remote)
Compensation: $60,000 - $72,000 / year (Based on experience)
Job Type: Full-Time
Industry: Insurance / Healthcare / Business Administration
About the Role
Are you an organized, detail-oriented office professional who thrives on solving puzzles, evaluating details, and helping customers navigate process guidelines? We are seeking a Claims Specialist to join our team in Lombard, IL.
In this role, you'll act as a neutral "referee"-evaluating incoming claims, reviewing medical records and policy documentation, interpreting guidelines, and ensuring accurate, fair outcomes for our customers. If you bring a strong customer service mindset combined with high administrative rigor, this is an excellent opportunity to expand your career in claims administration.
Key Responsibilities
Evaluate & Adjudicate Claims: Review incoming documentation, verify eligibility, and apply plan rules/policy guidelines consistently to determine claim outcomes.
Customer Communication: Serve as a primary point of contact for clients, members, and providers-explaining coverage rules, answering inquiries, and requesting additional documentation with empathy and clarity.
Information & Record Verification: Review medical records, billing statements, and legal/insurance correspondence for accuracy and completeness.
High-Volume Case Management: Manage an active queue of claims/files in a fast-paced environment while meeting quality, turnaround time, and accuracy standards.
Cross-Team Collaboration: Coordinate with internal billing, benefits, and legal teams to resolve discrepancies and ensure seamless processing.
Qualifications & Requirements
Experience: 4+ years of customer service-oriented office experience (Insurance, Healthcare Admin, Case Management, Medical Billing/Intake, or Corporate Customer Support preferred).
System & Administrative Skills: Proficiency with EMRs, CRMs, or claims management databases, with proven ability to log clear, detailed case notes.
Critical Thinking: Ability to objectively interpret rules, contracts, or policy guidelines without needing strict product-line specialization upfront.
Communication: Exceptional written and verbal communication skills; comfortable handling high-volume phone calls and written correspondence.
Location: Must live within commuting distance of Lombard, IL and be able to work on-site 3 days per week.
Language (Plus): Bilingual proficiency in Spanish/English is a strong asset!
Why You'll Love Working Here
Flexible Work Structure: Enjoy a 3/2 hybrid model (3 days in our Lombard office, 2 days working from home).
Competitive Pay: $60,000 - $72,000 annually, depending on experience.
Comprehensive Benefits: Health, dental, vision, 401(k) matching, and paid time off.
Growth & Development: Continuous training and clear pathways for internal career progression.
For California Applicants:
We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).
This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?
