Remote Health Insurance Compliance Examiner

Examination Resources, LLC; United States; Remote; USD 70,000 - 90,000; Full time

Job summary

A woman-owned small business is seeking an individual to analyze health insurance product submissions to ensure compliance with federal and state laws. The ideal candidate will have exceptional communication skills, proficiency in Microsoft Office, and at least two years of experience in health insurance policy review. This role is remote and requires the ability to adapt to changing priorities and work independently. Knowledge of the Affordable Care Act is essential.

Qualifications

• Minimum of 2 years of experience drafting or reviewing health insurance policy forms.
• Two years of work experience in a healthcare-related field.

Responsibilities

• Analyze health insurance product submissions for compliance.
• Deliver objections and recommendations on health insurance contracts.
• Maintain up-to-date understanding of health insurance policy changes.
• Participate in quality peer reviews.

Skills

Knowledge of the Affordable Care Act

Clinical aspects of health care delivery

Exceptional written and oral communication

Proficient in Microsoft Office

Ability to work independently

Adaptability to changing priorities

Education

MCM designation issued by Insurance Regulatory Examiners Society

Tools

Microsoft Office (Word, Excel, PowerPoint, Teams, Outlook)

Adobe Acrobat PDF

Job description

A woman-owned small business is seeking an individual to analyze health insurance product submissions to ensure compliance with federal and state laws. The ideal candidate will have exceptional communication skills, proficiency in Microsoft Office, and at least two years of experience in health insurance policy review. This role is remote and requires the ability to adapt to changing priorities and work independently. Knowledge of the Affordable Care Act is essential.