Sr Claims Examiner I

Penn Mutual•Philadelphia, PA

2d•$55,000 - $63,000

About The Position

We are seeking a Senior Claims Examiner I to join our team. This role is designed for an independent, self-sufficient professional responsible for managing death claims of moderate complexity. Responsibilities may include processing claims across Life, Annuity, RPS, or a combination of these lines of business. In this position, you will ensure accurate and timely claim processing in alignment with contract provisions, company policies, and regulatory requirements. While you will independently handle routine and moderately complex cases, highly complex or non-standard claims will be escalated for further review. This role serves as a developmental senior position, offering the opportunity to build advanced expertise, strengthen decision-making skills, and prepare for future growth within the organization.

Requirements

Strong attention to detail and organizational skills.
Ability to work independently and manage assigned workload efficiently.
Foundational knowledge of life insurance products and claims processes.
Strong customer service mindset with demonstrated professionalism, empathy, accountability and ownership.
Strong analytical mindset with proven problem-solving abilities and math skills.
Effective written and verbal communication skills.
Proficiency with digital tools and claims systems.
Demonstrated accuracy, organization skills, and ability to work to meet deadlines and SLAs.
Ability to learn and adapt to changing procedures and regulations.
Ability to work with others in a collaborative team environment.
Demonstrated ability to learn and apply new digital tools, including AI applications such as Microsoft CoPilot.
Bachelor’s degree preferred or equivalent work experience.
3–5 years of experience in life, annuity, or RPS claims or related field.

Nice To Haves

Industry certifications (e.g., ALHC, FLMI, Series 6 or 26, HIAA, etc.) are a plus but not required.

Responsibilities

Review and adjudicate standard and moderately complex life and annuity claims in compliance with policies and regulations.
Adjudicates and pays claims within established service level agreements (SLAs) up to $1M.
Validate beneficiary designations and process payments accurately within documented procedures and team SLAs.
Applies established procedures and regulatory guidelines to determine if requests are in “good order.”
Identify and escalate highly complex or unusual cases to senior team members or management.
Maintain accurate records and documentation for all claims handled.
Communicate effectively with beneficiaries, agents, and internal stakeholders to resolve inquiries and champion strong relationship building and customer service.
Navigate multiple administrative systems, workflows, and imaging tools simultaneously with a high level of organization and attention according to standard operating procedures (SOPs).
Participate in training and development activities to enhance technical knowledge and skills.
Adheres to Service Level Agreements (SLAs) and individual/team metrics.
Ability to work core business hours between 8:30 AM to 6:00 PM EST.