Carrier Senior Claims Oversight Analyst
Independence Pet Group
•$74,122 - $92,653•Remote
About The Position
Independence American Insurance Company (IAIC) is hiring for a Senior Carrier Operations Claims Analyst. This is a fully remote role based in the United States. The Senior Carrier Operations Claims Analyst (Carrier Operations Quality Claims Senior Analyst) provides oversight of delegated claims operations and serves as a subject matter expert for complex claims, coverage interpretation, appeals, and escalated claim matters. This role partners with internal stakeholders and third-party administrators to ensure claims are handled consistently, compliantly, and in accordance with carrier guidelines.
Requirements
- 5+ years of insurance claims, claims operations, compliance, quality, or related experience.
- Strong knowledge of claims handling, coverage interpretation, and regulatory requirements.
- Excellent analytical, problem-solving, communication, and stakeholder management skills.
Nice To Haves
- Experience working with TPAs, delegated authority programs, or carrier oversight functions.
- Experience supporting audits, compliance initiatives, fraud investigations, or process improvements.
- Bachelor’s degree in Business, Insurance, Risk Management, or a related field.
Responsibilities
- Review and provide recommendations on high-dollar, complex, and over-authority claims.
- Evaluate coverage determinations, appeals, exceptions, and other escalated claim matters.
- Identify claim trends, operational risks, and opportunities for improvement across administrator partners.
- Support audits, market conduct examinations, regulatory inquiries, and corrective action initiatives.
- Monitor administrator compliance with carrier requirements, policies, and regulations.
- Assist with fraud-related investigations, reporting, and risk mitigation activities.
- Analyze claims data, audits, and operational metrics to improve performance and outcomes.
- Review administrator workflows, procedures, and controls for effectiveness and compliance.
- Partner with stakeholders to implement process improvements and corrective action plans.
- Develop and maintain claims guidelines, governance standards, and operational procedures.
- Support ongoing enhancements to claims oversight and governance programs.
- Communicate policy updates, claims guidance, and operational requirements to stakeholders.
- Serve as a subject matter expert for claims oversight and delegated claims administration.
- Provide guidance, training, and support to team members and business partners.
- Participate in projects and initiatives that strengthen carrier operations and claims governance.
Benefits
- Comprehensive full medical, dental and vision Insurance
- Basic Life Insurance at no cost to the employee
- Company paid short-term and long-term disability
- 12 weeks of 100% paid Parental Leave
- Health Savings Account (HSA)
- Flexible Spending Accounts (FSA)
- Retirement savings plan
- Personal Paid Time Off
- Paid holidays and company-wide Wellness Day off
- Paid time off to volunteer at nonprofit organizations
- Commuter Benefits
- Group Pet Insurance
- On the job training and skills development
- Employee Assistance Program (EAP)
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
Upload and Match Resume
What This Job Offers
Job Type
Full-time
Career Level
Senior
