Claims Examiner

Position Summary

At Securian Financial, we are dedicated to providing exceptional service and fulfilling our commitments to customers, beneficiaries, employers, and business partners. As a Claims Examiner, you will investigate, evaluate, and adjudicate claims while balancing accuracy, timeliness, compliance, risk management, and customer experience. Successful candidates must possess analytical, detail-oriented, and effective communication skills, along with the ability to make sound decisions and manage multiple priorities.

Responsibilities

• Investigate, evaluate, and adjudicate claims in accordance with policy provisions, regulatory requirements, and company guidelines.
• Analyze claim information to determine coverage eligibility, benefit amounts, beneficiary entitlement, and claim validity.
• Gather and review information from customers, beneficiaries, employers, healthcare providers, funeral homes, and other internal and external partners.
• Communicate claim requirements, status updates, decisions, and next steps in a clear, timely, and professional manner.
• Proactively utilize phone, email, and written correspondence to support customers and facilitate timely claim resolution.
• Recognize opportunities where a direct conversation can improve understanding, reduce customer effort, and create a more positive customer experience.
• Maintain thorough claim records that support quality reviews, audits, regulatory requirements, and potential litigation.
• Ensure claim decisions, documentation, and payments are accurate, complete, and compliant.
• Partner with legal, medical, and investigative resources when additional expertise is needed.
• Contribute to process improvements, team initiatives, and special projects as assigned.
• Support workload continuity by assuming responsibility for in-progress claims during team transitions, ensuring uninterrupted service for customers.

Qualifications

• 2+ years of customer service experience.
• Strong analytical and problem-solving skills.
• Excellent attention to detail and organizational skills.
• Strong written and verbal communication skills.
• Demonstrated ability to make sound decisions and manage multiple priorities.
• Ability to learn and adapt to new and/or changing technologies and processes.
• Commitment to providing a high-quality customer experience.

Preferred Qualifications

• Knowledge of employer-sponsored life insurance, waiver of premium, accelerated death benefit, or related insurance products.
• Experience adjudicating insurance claims.
• Experience working in administrative, claims, or workflow management systems.
• Experience building positive relationships with customers, business partners, and other stakeholders.
• Proficiency with Microsoft Outlook, Word, and Excel.
• Curiosity and willingness to learn and leverage AI-enabled tools to improve efficiency, decision-making, and the customer experience.