Life Claims Examiner
About The Position
We are hiring a Life Claims Examiner to play a critical role in delivering accurate and compliant claim outcomes while supporting beneficiaries and internal stakeholders throughout the claims process. This position is responsible for the preparation, review, and adjudication of life insurance claims and distributions in accordance with policy provisions, plan parameters, regulatory requirements, and state interest rules. The role ensures timely, compliant, and customer focused resolution through effective coordination with internal teams, external partners, agents, and beneficiaries, while adhering to company and carrier standards.
Requirements
- Minimum of 5 years of life insurance claims adjudication experience.
- Demonstrated knowledge of permanent life insurance products, including non-forfeiture options and benefit extension riders.
- Knowledge of underwriting principles and applicable state regulations.
- Strong analytical, investigative, and decision-making skills.
- Proficiency in MS Office and database research tools.
Responsibilities
- Validate claimant, beneficiary, and claim-specific data for accuracy and completeness; enter and maintain detailed claim information in administrative and claim tracking systems.
- Review incoming life insurance claims to assess completeness and required documentation, including death certificates, claim forms, and legal documents.
- Verify policy coverage, beneficiary designation, eligibility, and benefit provisions.
- Request and obtain additional information from internal and external sources to support claim determination.
- Adjudicate claims in compliance with applicable laws, regulations, IRS guidelines, plan parameters, and processing guidelines.
- Investigate questionable transactions or discrepancies and report suspected fraud in accordance with company and carrier guidelines.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
