This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

We are seeking a detail-oriented and customer-focused professional to join our team as a Life Claims Analyst. In this role, you will ensure the accurate, timely, and comprehensive assessment of claims by carefully analyzing documentation, verifying information, and determining appropriate next steps.

• Evaluates and adjudicates complex claims by reviewing medical records, contract language, and supporting documentation to determine accurate and timely payment or denial decisions.
• Processes claim transactions and inquiries by analyzing documentation, keying data accurately, drafting determination letters, and communicating outcomes clearly to internal and external customers.
• Delivers exceptional customer service across multiple channels, resolves escalations, applies service recovery techniques, and builds customer loyalty through clear, compliant communication.
• Ensures compliance and quality standards by adhering to company policies, industry regulations, productivity benchmarks, and making appropriate referrals (e.g., legal, underwriting, investigations) when necessary.
• Contributes to team and process excellence by supporting training and peer development, participating in process improvements, maintaining strong working relationships, and continuously expanding knowledge and skills.

Qualifications

• Demonstrates accountability and urgency, consistently delivering accurate results while meeting deadlines in a fast-paced environment.
• Adapts quickly to change, shows flexibility, learns new skills readily, and effectively manages multiple tasks and priorities.
• Works independently and collaboratively, building positive relationships while remaining approachable and team-oriented.
• Exhibits strong analytical, organizational, and decision-making skills, with attention to detail and the ability to operate within structured, compliant guidelines.
• Communicates effectively and maintains customer focus, utilizing strong technical skills, handling escalations professionally, and meeting attendance and flexibility requirements.
• Promotes a culture of diversity and inclusion, values different ideas and opinions, and listens courageously, remaining curious in all that you do.
• Able to work remotely with access to a high-speed internet connection and located in the United States or Puerto Rico.

Requirements

• College degree or work equivalent.
• Insurance product knowledge of Business area.
• Experience with the application of policies, practices and procedures in a business environment.
• Knowledge of medical terminology.
• Presentation skills.

Benefits

• Hourly Wage: Minimum: $22.25, plus annual bonus opportunity.
• 401(k) plan with a 2% company contribution and 6% company match.
• Work-life balance with vacation, personal time and paid holidays.