Life Claims Examiner
Core
Adjudicate group life and AD&D claims, verify eligibility, and make initial claim decisions based on policy provisions.
Role type
Life Claims Examiner
Builds
Accurate payments to beneficiaries and defensible claim records
Domain
Insurance (Life & AD&D)
Deliverable
client delivery
Required skills
Policy interpretation, regulatory compliance, claim system proficiency, payment processing, beneficiary communication, eligibility verification
Preferred skills
Previous life claims experience, 1-2 years cumulative relevant experience
Responsibilities
Review and investigate claims to determine eligibility; interpret and apply contract provisions; communicate claim status and decisions to policyholders and beneficiaries; maintain defensible claim records; educate policyholders and agents on policy administration; identify and correct policy language discrepancies.