Associate Life Insurance Claims Examiner

4 weeks ago


Amarillo, Texas, United States Health Care Service Corporation Full time

**Job Summary**

Under the supervision of a senior claims examiner, this position is responsible for reviewing and processing life, waiver of premium, AD & D, Critical Illness, and Accident Insurance claims for Group Insurance policies. The successful candidate will perform a variety of related duties, including timely follow-up, accurate assessment of supporting information, and appropriate adjudication of these claims with optimum outcomes and customer service.

**Key Responsibilities:**

  • Review and process life, waiver of premium, AD & D, Critical Illness, and Accident Insurance claims for Group Insurance policies.
  • Perform timely follow-up on claims to ensure accurate and efficient processing.
  • Assess supporting information to determine claim eligibility and make informed decisions.
  • Adjudicate claims with optimum outcomes and customer service.
  • Collaborate with internal stakeholders to resolve claims-related issues.

**Requirements:**

  • Bachelor's degree or 4 years of business experience.
  • PC proficiency to include Microsoft Word, Excel, and Outlook.
  • Excellent customer service skills.
  • Excellent math aptitude, analytical, and critical thinking skills.
  • Problem-solving and research skills.
  • Experience handling multiple tasks and managing priorities.
  • Clear and concise verbal and written communication skills.

**Preferred Qualifications:**

  • LOMA courses.
  • Knowledge of state regulations, statutes, and ERISA.
  • Knowledge of medical and insurance terminology.
  • Ability to fluently speak and write Spanish.

**Work Arrangement:**

This is a flex role working 3 days in the office and 2 days from home.



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