Claims Exception Analyst – LER

This is a fully remote position, open to applicants in United States.

📋 Description

• Primarily tasked with assessing and adjudicating claims exception requests in accordance with established work instructions.

• Occasionally responsible for adjudicating higher-risk exceptions that are not governed by established work instructions but are supported by broader policies and agreements.

• Efficiently track, log, and monitor claims in progress.

• Navigate, prioritize, and execute client assignments in a dynamic, fast-paced environment.

• Demonstrated ability to monitor, identify, and flag emerging risk trends as necessary.

• Strong verbal and written communication skills with both internal and external partners.

• Uphold the confidentiality of information pertaining to customers, clients, and/or associates.

• Act as a resource for team members by addressing and resolving policy inquiries, policy terms, program procedures, cancellation status questions, etc.

• Maintain accurate and thorough knowledge of products, policy terms and coverages, and program procedures.

• Research and review exception decisions to validate their accuracy and adherence to program enrollment.

• Possess strong organizational skills to manage ambiguity effectively.

• Consistently meet established team quality, productivity, and/or performance targets.

• Show readiness to undertake additional tasks to support team initiatives as needed.

⛳️ Requirements

• Must have or be willing to obtain a valid Insurance License.

• Must have or be willing to obtain a valid Home State Property & Casualty License.

• General proficiency in using Microsoft Office tools.

• Availability to work nights and/or weekend shifts.

🏝️ Benefits

• Health insurance.

• Employee discounts.