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Aegon · 1 day ago

Sr. Claims Examiner

United States

Full-time

Remote

Mid, Senior Level

$48K/yr - $55K/yr

5+ years exp

Aegon is a company focused on providing financial protection and investment solutions, and they are seeking a Senior Claims Examiner. The role involves evaluating and analyzing documentation for claim payments or denials, managing claims reviews, and ensuring compliance with regulations.

Asset ManagementAuto InsuranceFinanceHealth InsuranceInsuranceLife InsuranceRetirement

No H1B

Responsibilities

Analyze information/documentation received to determine how to proceed with a review of a claim and determine methods of obtaining additional information from alternative sources

Manage the review of a claim and outside sources used in the review

Document correspondence and conversations

Correspond verbally and in writing with claimants, medical providers, medical examiners, and law enforcement

Work closely with department manager, legal counsel, medical director, claims assistants, and other departments to gather information for contested claims

Monitor claims for fraud and proceed according to each situation, such as engaging the Fraud team or conducting additional research

Maintain compliance with regulations

May testify in depositions, hearings and trials; communicate the Company’s position regarding the claim

Assist peers with processing questions in the absence of higher level staff

May serve as a back up to review and authorize pending payments calculated by peers, within approval authority

Qualification

Claims experienceRegulatory compliance knowledgeLifeAnnuity productsCustomer service skillsAnalytical skillsMulti-taskCommunicationOrganizational skillsProblem-solving skillsAdaptability