Benefit Claims Technician

Job Summary

Evaluating and adjudicating Group Claims for Accident, Critical Illness, and Hospital Indemnity, the full-time remote Benefit Claims Technician will manage end-to-end claims processing while ensuring timely and accurate decisions to enhance customer experience.

Key responsibilities

• Independently evaluate claims by gathering and analyzing relevant information to make sound decisions based on policy provisions
• Maintain professional communication and build strong relationships with claimants, employers, brokers, and internal teams
• Ensure accurate financial determinations and eligibility assessments using salary data, contract terms, and medical documentation

Required qualifications

• Experience working with insurance claims, preferably in Accident, Critical Illness, and Hospital Indemnity products
• Demonstrated ability to analyze complex insurance and medical data and apply regulatory knowledge to claims decisions
• Proficient in calculating benefits from basic to complex levels using policy provisions and supporting documentation
• Highly organized with strong attention to detail and ability to manage priorities effectively
• Ability to work remotely with access to a high-speed internet connection while located in the United States