Senior Claims Examiner

Job Summary

Evaluating and analyzing documentation for claim payments or denials, the full-time Senior Claims Examiner will manage claims reviews, correspond with various stakeholders, and ensure compliance with regulations while working remotely.

Key responsibilities

• Analyze information and documentation to determine claim review procedures and gather additional information as needed
• Document correspondence and manage communication with claimants, medical providers, and other relevant parties
• 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
• Five years of claims experience
• In-depth understanding of life and annuity product language and regulatory compliance
• Ability to cross-train and learn about other products
• Experience in documenting and managing claims-related communications