Claims Examiner

Position Summary: At Securian Financial, we are committed to providing exceptional service and delivering on our promises 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 are analytical, detail-oriented professionals who communicate effectively, exercise sound judgment, and leverage a variety of communication methods to support customers, gather information, and resolve claims efficiently while delivering a positive and compassionate customer experience. Responsibilities include but are not limited to: 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. Ability to navigate sensitive situations with empathy, professionalism, and strong judgement. 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. The internal title for this role is Customer Benefits Payments Sr Rep or Customer Benefit Payments Specialist. This role may be filled at the Sr Rep or Specialist level, depending on the candidate's background and experience. Candidates considered for the Specialist level should have prior claims examiner experience or comparable, significant experience in a related area. Preferred Skills: Critical Thinking, Decision Making, Detail-Oriented, Team Collaboration, Workload Prioritization, Written Communication The estimated base pay range for this job is: $18.80 - $32.69 Pay may vary depending on job-related factors and individual experience, skills, knowledge, etc. More information on base pay and incentive pay (if applicable) can be discussed with a member of the Securian Financial Talent Acquisition team. Be you. With us. At Securian Financial, we understand that attracting top talent means offering more than just a job - it means providing a rewarding and fulfilling career. As a valued member of our high-performing team, we want you to connect with your work, your relationships and your community. Enjoy our comprehensive range of benefits designed to enhance your professional growth, well-being and work-life balance, including the advantages listed here: Paid time off: We want you to take time off for what matters most to you. Our PTO program provides flexibility for associates to take meaningful time away from work to relax, recharge and spend time doing what's important to them. And Securian Financial rewards associates for their service by providing additional PTO the longer you stay at Securian. Leave programs: Securian’s flexible leave programs allow time off from work for parental leave, caregiver leave for family members, bereavement and military leave. Holidays: Securian provides nine company paid holidays. Company-funded pension plan and a 401(k) retirement plan: Share in the success of our company. Securian’s 401(k) company contribution is tied to our performance up to 10 percent of eligible earnings, with a target of 5 percent. The amount is based on company results compared to goals related to earnings, sales and service. Health insurance: From the first day of employment, associates and their eligible family members - including spouses, domestic partners and children - are eligible for medical, dental and vision coverage. Volunteer time: We know the importance of community. Through company-sponsored events, volunteer paid time off, a dollar-for-dollar matching gift program and more, we encourage you to support organizations important to you. Associate Resource Groups: Build connections, be yourself and develop meaningful relationships at work through associate-led ARGs. Dedicated groups focus on a variety of interests and affinities, including: Environmental Health & Sustainability Mental Wellness and Disability Pride at Securian Financial Securian Young Professionals Network Securian Multicultural Network Securian Women and Allies Network Servicemember Associate Resource Group For more information regarding Securian’s benefits, please review our Benefits page. This information is not intended to explain all the provisions of coverage available under these plans. In all cases, the plan document dictates coverage and provisions. Securian Financial Group, Inc. does not discriminate based on race, color, religion, national origin, sex, gender, gender identity, sexual orientation, age, marital or familial status, pregnancy, disability, genetic information, political affiliation, veteran status, status in regard to public assistance or any other protected status. If you are a job seeker with a disability and require an accommodation to apply for one of our jobs, please contact us by email at View email address on click.appcast.io, by telephone View phone number on click.appcast.io (voice), or 711 (Relay/TTY). Securian Financial is a drug-free workplace. To view our privacy statement click here To view our legal statement click here #J-18808-Ljbffr Securian