This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Senior Claims Examiner in the United States.
The Senior Claims Examiner will play a critical role in reviewing, analyzing, and adjudicating life insurance claims with accuracy, efficiency, and professionalism. This position involves evaluating complex claims, collaborating with internal teams, and ensuring compliance with regulatory requirements while maintaining high standards of customer service. The successful candidate will provide guidance on claim decisions, support audits, mentor junior staff, and contribute to process improvement initiatives. This role offers an opportunity to make a tangible impact on clients’ experiences while working in a dynamic, data-driven, and collaborative environment.
Accountabilities:- Review and adjudicate life insurance claims, ensuring accuracy, completeness, and compliance with policies and regulations.
- Evaluate complex contestable and accidental death benefit claims and confirm benefits and statutory interest calculations.
- Communicate effectively with customers, attorneys, co-workers, and management regarding claim matters.
- Collaborate with Legal, Underwriting, Actuarial, and Finance teams to resolve complex issues and provide data-driven insights.
- Maintain detailed documentation of claim decisions, follow-ups, and communication in accordance with departmental procedures.
- Mentor and support third-party claim administration staff and provide guidance on best practices.
- Monitor trends in claims experience, escalate issues, and recommend corrective actions.
- Support audits, regulatory inquiries, and special projects as required.
Requirements:
Candidates should have extensive experience and demonstrated skills in claims management and regulatory compliance. Required qualifications include:
- Minimum of 5 years of life insurance claims experience, with proficiency in contestable and accidental death benefit claims preferred.
- Knowledge of medical terminology, insurance policies, regulatory compliance, privacy requirements, and NAIC policy locators.
- Strong analytical, problem-solving, and organizational skills with attention to detail.
- Excellent written, verbal, and interpersonal communication skills.
- Proficiency in Microsoft Office applications and basic mathematical calculations.
- Ability to maintain confidentiality, exercise judgment, and work independently, including in a remote setting if applicable.
- Flexibility and adaptability to changing responsibilities and emergency call coverage.
- Completion of LOMA or ICA Claims Education courses preferred; legal or paralegal certifications are optional but beneficial.
Benefits:
- Competitive salary range: $70,720 - $91,520
- Medical, dental, and vision insurance with employer-paid coverage for vision
- Employer-paid basic life and AD&D insurance, short-term and long-term disability coverage
- 401(k) plan with company match
- Paid time off and sick leave accrual
- Annual performance-based bonus program
- Opportunities for professional development and career growth
Why Apply Through Jobgether?
We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.
We appreciate your interest and wish you the best!
Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.
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