Life and Health Claims Specialist

Job Summary

A company is looking for a Claims Specialist II, Life & Health.

Key Responsibilities

• Train and provide quality assurance for the Claims team, developing training materials and monitoring work quality
• Adjudicate complex claim requests, ensuring procedural and dollar accuracy while handling adjustments and complaints
• Manage projects to enhance department development and improve processes, including the evaluation and modification of existing systems and procedures

Required Qualifications

• Experience in claims processing, specifically in Life and Health insurance
• Proven ability to manage projects and develop training programs
• Strong analytical skills to evaluate department needs and implement improvements
• Ability to maintain high accuracy standards in claims adjudication
• Familiarity with insurance policies and procedures