Claims Management Specialist

Job Summary

A company is looking for a Claims Management Specialist (TPA Oversight) to provide oversight of the third-party administrator claims examination process.

Key Responsibilities

• Provide oversight of the TPA's claim examination process to ensure accuracy, compliance, and timely resolution
• Review and approve claim payments within delegated authority limits
• Manage and resolve beneficiary disputes, including coordination with internal stakeholders and external partners

Required Qualifications

• Proven experience in life insurance and claims management
• Background handling contestable, complex, or sensitive claims
• Strong understanding of claims regulations and policy interpretation
• Experience working with or overseeing third-party administrators
• Demonstrated ability to operate in an oversight-focused role