Senior Claims Examiner

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

📋 Description

• Evaluate information and documentation to decide the approach for claim reviews.

• Identify methods for acquiring supplementary information from alternative sources.

• Oversee claim reviews and the external sources utilized in these evaluations.

• Record correspondence and discussions meticulously.

• Engage verbally and in writing with claimants, medical providers, medical examiners, and law enforcement officials.

• Collaborate with the department manager, legal counsel, medical director, claims assistants, and other departments on disputed claims.

• Monitor claims for fraudulent activity and involve the Fraud team or conduct further research as necessary.

• Ensure adherence to regulatory requirements.

• Provide testimony in depositions, hearings, and trials as required.

• Communicate the Company’s stance regarding claims effectively.

• Support colleagues with processing inquiries in the absence of senior staff members.

• Act as a backup to review and authorize pending payments within the designated approval authority.

⛳️ Requirements

• An Associate’s degree in a business-related field or equivalent experience.

• A minimum of five years of claims experience.

• Comprehensive knowledge of life and annuity product language, provisions, and regulatory/compliance rules and regulations.

• Exceptional communication and customer service abilities.

• Strong organizational, problem-solving, and analytical skills.

• Capacity to cross-train and acquire knowledge of other products.

• Ability to manage multiple tasks and adapt to changing circumstances.

• Candidates must be authorized to work for any employer in the U.S.

• No sponsorship of an employment visa is available.

🏝️ Benefits

• Competitive Pay

• Bonus for Eligible Employees

• Pension Plan

• 401k Match

• Employee Stock Purchase Plan

• Tuition Reimbursement

• Disability Insurance

• Medical Insurance

• Dental Insurance

• Vision Insurance

• Employee Discounts

• Career Training & Development Opportunities

• Paid Time Off starting at 160 hours annually for employees in their first year of service

• Ten (10) paid holidays per year

• Be Well Company holistic wellness program, which includes Wellness Coaching and Reward Dollars

• Parental Leave – fifteen (15) days of paid parental leave per calendar year for eligible employees with at least one year of service

• Adoption Assistance

• Employee Assistance Program

• Back-Up Care Program

• PTO for Volunteer Hours

• Employee Matching Gifts Program

• Employee Resource Groups

• Inclusion and Diversity Programs

• Employee Recognition Program

• Referral Bonus Programs