Intermediate Claims Examiner

Job Summary

Evaluating and analyzing claim documentation for payments or denials, the full-time Intermediate Claims Examiner will work remotely to determine claim outcomes, gather information, and maintain compliance with regulations.

Key responsibilities

• Analyze information and documentation to determine claim review processes and obtain additional data as needed
• Document correspondence and communicate with claimants, medical providers, and other stakeholders regarding claims
• Monitor claims for potential fraud and collaborate with various departments to resolve contested claims

Required qualifications

• Associate's degree in a business field or equivalent experience
• Two years of claims experience
• Strong understanding of life and annuity product language and regulatory compliance
• Ability to cross-train and learn about other products
• Experience in a remote call center environment is preferred