Associate, Claim Representative - Operations

Job Title

Sr. Associate Claims & Document Processing

Job Description

This role ensures timely and accurate processing of claims, supports internal and external audits, and contributes to operational efficiency. The Sr. Associate works cross-functionally to resolve issues and maintain high standards of data integrity and client service. In addition, this role provides day-to-day oversight of the document function, including Document Capture and Document Indexing, ensuring that document workflows, quality assurance, and processing standards are consistently met. The Sr. Associate partners closely with document operations staff, providing guidance, identifying issues, and ensuring readiness for downstream claim processing.

Responsibilities

Claim Representative

• Perform adjudication of life claims for assigned clients, including standard and contestable cases.
• Review claim documentation such as death certificates, claimant statements, and policy records to verify eligibility.
• Assess claim validity based on treaty terms, policy provisions, and underwriting guidelines.
• Assist with performance of client adjudication audits for assigned clients to ensure compliance with treaty terms and adjudication standards.
• Serve as liaison to clients for claim-related inquiries
• Review and approve claims in accordance with claim payment approval hierarchy.
• Review, enhance, and sign settlements to ensure timely client payments
• Process claim refunds appropriately and timely.
• Monitor workflow and identify potential claims processing issues.
• Work cross-functionally to resolve system impediments to claim payment processing.
• Identify opportunities for improvement and contribute to process enhancements.
• Assist with internal and external audits and ensure all ICS controls are properly documented.
• Establish requirements for system enhancements and log tickets for tracking, UAT testing, and implementation.
• Creation and maintenance of reports allowing for analysis of claim workflow and data fields to ensure accuracy of claim data.
• Analyze client trending data to understand financial results and identify potential future impact.
• Produce ad-hoc reports and claims metrics for management and other stakeholders.
• Perform monthly and quarterly reporting requirements for performance measurement and to meet quarter end deliverables.
• May perform other duties as required.

Document Capture and Indexing Oversight

• Provide functional guidance, without direct supervisory authority, to Document Capture and Indexing staff to ensure compliance with procedures and quality standards.
• Act as the first point of support when issues related to documents, workflow, AIssistant implementation occurs.
• Monitor document workflow and escalate systemic issues, volume concerns, and recurring quality defects.
• Communicate expectations, process clarifications, and system changes affecting document operations.
• Serve as a subject?matter resource for document processing questions from internal teams.
• Collaborate with document representatives to improve consistency, reduce rework, and strengthen data integrity.

Qualifications

• Undergraduate degree in business administration with an emphasis in accounting/finance or equivalent work experience

• Advanced degree or industry certification preferred

• 1-3 years of experience in life claims administration and adjudication or related insurance operations
• Understanding of claim treaty provisions, adjudication thresholds, and regulatory compliance.
• Proficiency in manipulating Adobe PDFs.
• Strong analytical and decision-making skills with attention to detail and accuracy.
• Strong problem-solving skills and the ability to navigate and resolve complex issues.
• Strong analytical and organizational skills.
• Proficiency in claims systems and reporting tools.
• Ability to work independently and collaboratively across teams.
• Ability to quickly learn new systems, technology tools, and document management platforms
• Excellent communication and problem-solving skills.
• Proficiency in Microsoft Excel preferred (V?Lookups, PivotTables, formulas).

Relocation assistance within the U.S. is available for this position.

Candidates must have valid authorization to work in the U.S. without the need for employer sponsorship now or in the future.

Hybrid Work Policy: SCOR is committed to an "in office" culture where people can collaborate, exchange ideas, and establish stronger working relationships

while still providing flexibility. To support employee work-life balance and increase opportunities for employees to excel every day, SCOR operates with a hybrid working arrangement.

SCOR employees work 3 days per week in an office with the flexibility to work 2 days per week remotely.

Pay Range for roles performed in NC & KS: $72,000-$88,000 base salary per year. Actual salaries may vary based on various factors including but not limited to location, experience, role and performance. The range listed is just one component of SCOR's total compensation package for employees.

Other rewards may include annual bonuses, short- and long term incentives.

In addition, we provide a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement saving plan, paid holidays and paid time off.

Job Info

• Job Identification 4944
• Job Category Claims & Commutation
• Locations 101 South Tryon Street, Charlotte, NC, 28280, US

About Us

As a leading global reinsurer, SCOR offers its clients a diversified and innovative range of reinsurance and insurance solutions and services to control and manage risk. Applying "The Art & Science of Risk," SCOR uses its industry-recognized expertise and cutting-edge financial solutions to serve its clients and contribute to the welfare and resilience of society in around 160 countries worldwide.

Working at SCOR means engaging with some of the best minds in the industry actuaries, data scientists, underwriters, risk modelers, engineers, and many others as we work together to find solutions to pressing challenges facing societies.

As an international company, our common culture is defined by "The SCOR Way." Serving both to build momentum that drives the Group forward and as a compass to guide our actions and choices, The SCOR Way is anchored by five core values, reflecting the input of employees at all levels of the Group. We care about clients, people, and societies. We perform with integrity. We act with courage. We encourage open minds. And we thrive through collaboration.

SCOR supports inclusion and the diversity of talents, and all positions are open to people with disabilities.