Medical Specialist Principal – Life Company Medical Supplement Claims

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.

Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity USAA Life Company’s Claim Team is seeking a talented Medical Specialist Principal to play a crucial role in advising the Medicare Supplement Claims Department on the morbidity and claims risk of health policies, including Medicare Supplement contracts and claims.

The responsibilities will include providing support to investigators related to Medical Procedures and CPT coding issues and fraud waste and abuse activity. You will participant in settlement negotiations when they’ve provided assistance in performing medical and coding reviews. Your responsibilities will include reviewing complicated medical histories, assessing medical testing results, and ensuring claims payment accuracy in accordance with Centers for Medicare & Medicaid Services (CMS) guidelines.

Additional responsibilities include: Regularly reviewing USAA Life Company’s actual morbidity and claims experience to safeguard long-term morbidity outcomes; providing expert medical consultation on Medicare Supplement policies and claims; conducting research on medical advancements and public health trends, including trends involving fraud, waste, and abuse, to ensure that risk assessment strategies are current and effective