Claims Examiner
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Job Description
Claims Examiner responsible for adjudicating and processing supplemental insurance claims at The Standard. Ensuring compliance and providing customer service throughout the claims process.
Responsibilities:
- Review, adjudicate, and approve claims and payments accurately and timely, ensuring compliance with policies, coverage provisions, and service standards.
- Perform end‑to‑end claims intake and validation, including eligibility verification, documentation review, discrepancy resolution, and benefit calculation.
- Execute and manage the full payment lifecycle, including authorizations, EOB verification, distribution, and resolution of payment issues.
- Communicate effectively with claimants, policyholders, employers, brokers, and internal partners to provide status updates, resolve issues, and deliver responsive customer service.
- Maintain accurate claim and financial records while driving continuous improvement through process analysis, workflow enhancements, and cross‑functional collaboration.
Requirements:
- Education: High School Diploma required, bachelor’s degree in business or related field preferred.
- Experience: 1+ years of experience in claims submission, communication, eligibility verification, or processing
- Experience with supplemental insurance claims preferred
- Basic proficiency in Microsoft Office (Word, Outlook, Teams)
- Familiarity with claims management strategies and customer service preferred
- Ability to handle complex claim issues and contribute to process improvements preferred
Benefits:
- A rich benefits package including medical, dental, vision and a 401(k) plan with matching company contributions
- An annual incentive bonus plan
- Generous paid time off including 11 holidays, 2 wellness days, and 8 volunteer hours annually — PTO increases with tenure
- A supportive, responsive management approach and opportunities for career growth and advancement
- Paid parental leave and adoption/surrogacy assistance
- An employee giving program that double matches your donations to eligible nonprofits and schools
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