Life Claims Examiner
Core
Adjudicate group life and Accidental Death & Dismemberment (AD&D) claims from start to finish, verifying eligibility, making decisions based on policy provisions, and issuing payments to beneficiaries.
Role type
Claims Examiner (Life & AD&D)
Builds
Accurate claim decisions and payments for group life insurance policies
Domain
Insurance / Life & AD&D Claims
Deliverable
client delivery
Required skills
Claims adjudication, policy interpretation, eligibility verification, beneficiary identification, payment processing, record maintenance, complex case resolution, process improvement
Preferred skills
Salesforce experience, group life/AD&D/disability benefits experience
Responsibilities
Review and adjudicate group life and AD&D claims; Investigate eligibility and gather supporting information; Identify correct beneficiaries and issue accurate payments; Communicate claim status and decisions; Maintain accurate claim records; Partner with legal and external resources to resolve complex questions; Guide policyholders and brokers on policy administration; Identify opportunities to improve claims processes
Seniority
Mid-level, hands-on IC