Senior Claims Analyst

1 week ago

Dallas, TX, United States Sutherland Full time
Company Description

As a digital transformation company -- and Great Place to Work certified -- Sutherland has been helping customers globally achieve greater agility and transform automated customer experiences for over 35 years. We work with some of the world's most known brands in dozens of industries, including Banking & Financial Services; Insurance; Communications, Media & Entertainment; Healthcare; Retail & Consumer Packaged Goods; Technology; Travel, Transportation, Hospitality & Logistics; and Mortgage Services, helping them to better support and serve their customers.

Job Description

Sr. Claim Examiner is responsible for administering quality assurance and continuous improvement initiatives, ensuring accuracy in claims processing, payment validation, and data management.

Key Responsibilities
  • Conduct audits and quality reviews to ensure compliance with regulatory requirements and internal procedures.
  • Oversee the department's quality program, including process updates, documentation, and workflow optimization.
  • Manage reporting, data analysis, and other operational tasks to improve visibility and performance across the team.
  • Train Claims Analysts on call monitoring, audit techniques, and best practices.
  • Identify trends, communicate insights, and provide coaching to team members to support ongoing quality development.
Qualifications
  • Bachelor's Degree or equivalent work experience.
  • Minimum 5 years of experience in Life/Health claims, underwriting, or a closely related insurance field.
  • Strong knowledge of insurance regulations, claims practices, privacy requirements, and investigation tools.
  • Excellent written and verbal communication skills, with proven ability to coach and influence others.
  • Highly organized with strong project management skills and the ability to manage multiple priorities in a fast-paced environment.
  • Proficiency with Microsoft Office; ability and willingness to learn data/reporting tools (e.g., Power BI, Python).


Additional Information

EEOC and Veteran Documentation
During employment, employees are treated without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap, or any other legally protected status.
At times, government agencies require periodic reports from employers on the sex, ethnicity, handicap, veteran and other protected status of employees. The purpose of this Administrative EEO Record is for statistical analysis only and is used to comply with government record keeping, reporting, and other legal requirements. Periodic reports are made to the government on the following information. The completion of the Administrative EEO record is optional. If you choose to volunteer the requested information, please note that all
Administrative EEO Records are kept in a Confidential File and are not part of your Application for Employment or Personnel file.
Please note: YOUR COOPERATION IS VOLUNTARY. INCLUSION OR EXCLUSION OF ANY DATA WILL NOT AFFECT ANY EMPLOYMENT DECISION.

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