Sr Claims Examiner I

Penn Mutual•Philadelphia, PA

2d•$55,000 - $65,000

About The Position

The Sr Claims Examiner I is an independent and self-sufficient professional who handles death claims with moderate complexity. This may include processing claims within Life, Annuity, RPS, or a combination of the three. This role ensures accurate processing in accordance with contract provisions, policies, and regulatory guidelines. While capable of handling routine and moderately complex cases independently, highly complex or unusual cases are escalated for review. This position serves as a developmental senior role, building expertise and judgment for future advancement.

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.