Claims Examiner
About The Position
At Securian Financial, we are committed to providing exceptional service and delivering on our promises to customers, beneficiaries, employers, and business partners. As a Claims Examiner, you will investigate, evaluate, and adjudicate claims while balancing accuracy, timeliness, compliance, risk management, and customer experience. Successful candidates are analytical, detail-oriented professionals who communicate effectively, exercise sound judgment, and leverage a variety of communication methods to support customers, gather information, and resolve claims efficiently while delivering a positive and compassionate customer experience.
Requirements
- 2+ years of customer service experience.
- Strong analytical and problem-solving skills.
- Excellent attention to detail and organizational skills.
- Strong written and verbal communication skills.
- Demonstrated ability to make sound decisions and manage multiple priorities.
- Ability to learn and adapt to new and/or changing technologies and processes.
- Commitment to providing a high-quality customer experience.
Nice To Haves
- Knowledge of employer-sponsored life insurance, waiver of premium, accelerated death benefit, or related insurance products.
- Experience adjudicating insurance claims.
- Ability to navigate sensitive situations with empathy, professionalism, and strong judgement.
- Experience working in administrative, claims, or workflow management systems.
- Experience building positive relationships with customers, business partners, and other stakeholders.
- Proficiency with Microsoft Outlook, Word, and Excel.
- Curiosity and willingness to learn and leverage AI-enabled tools to improve efficiency, decision-making, and the customer experience.
Responsibilities
- Investigate, evaluate, and adjudicate claims in accordance with policy provisions, regulatory requirements, and company guidelines.
- Analyze claim information to determine coverage eligibility, benefit amounts, beneficiary entitlement, and claim validity.
- Gather and review information from customers, beneficiaries, employers, healthcare providers, funeral homes, and other internal and external partners.
- Communicate claim requirements, status updates, decisions, and next steps in a clear, timely, and professional manner.
- Proactively utilize phone, email, and written correspondence to support customers and facilitate timely claim resolution.
- Recognize opportunities where a direct conversation can improve understanding, reduce customer effort, and create a more positive customer experience.
- Maintain thorough claim records that support quality reviews, audits, regulatory requirements, and potential litigation.
- Ensure claim decisions, documentation, and payments are accurate, complete, and compliant.
- Partner with legal, medical, and investigative resources when additional expertise is needed.
- Contribute to process improvements, team initiatives, and special projects as assigned.
- Support workload continuity by assuming responsibility for in-progress claims during team transitions, ensuring uninterrupted service for customers.
Benefits
- Paid time off
- Leave programs: parental leave, caregiver leave for family members, bereavement and military leave.
- Nine company paid holidays.
- Company-funded pension plan and a 401(k) retirement plan
- Medical, dental and vision coverage from the first day of employment.
- Volunteer paid time off
- Dollar-for-dollar matching gift program
- Associate Resource Groups
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
