Claims Specialist

Job Description

Job Description

We are looking for an Claims Specialist to join a financial services organization in Blue Ash, Ohio in a contract-to-permanent capacity. This role supports claimants, beneficiaries, agents, and related partners by guiding them through the claims process with empathy, accuracy, and professionalism. The position is responsible for managing life insurance claim activity from initial notice through payment and policy closure while ensuring documentation is complete and decisions align with policy terms and applicable regulations.

Responsibilities:

• Serve as a primary point of contact for claimants, beneficiaries, agents, and funeral homes by explaining benefit information, outlining required paperwork, and clarifying the next steps after a reported death.

• Drive claims toward resolution by following up on missing documents, responding to inbound inquiries, and maintaining consistent communication with all involved parties.

• Handle sensitive or emotional conversations with professionalism, using sound judgment and clear communication to address concerns and provide accurate guidance.

• Oversee the end-to-end claims workflow, including gathering proof of death, reviewing policy provisions, determining benefit eligibility, and processing payments in accordance with state requirements.

• Build and maintain well-organized claim files that include applications, beneficiary records, correspondence, supporting materials, and all required evidence.

• Review payment calculations for accuracy, document supporting details, and prepare files for internal approval before funds are released.

• Update policy administration records after claim approval, including completing policy status changes and final termination activities when appropriate.

• Maintain claim tracking tools, audit imaged records, and complete required reconciliation tasks to support timely, accurate, and fully documented claim handling.

• Investigate questionable matters when needed, perform policy research, and elevate concerns related to contestability, potential fraud, or rescission with clear supporting recommendations.

• Experience supporting insurance claims, authorizations, or related administrative processes in a regulated environment.
• Ability to manage inbound calls and written communications with claimants, beneficiaries, agents, and other external contacts.
• Knowledge of insurance claim handling practices, policy review, and documentation requirements.
• Strong attention to detail with the ability to verify calculations, maintain accurate records, and track multiple open items at once.
• Demonstrated skill in handling confidential financial and personal information with discretion and professionalism.
• Effective problem-solving and judgment skills, including the ability to identify issues that require further investigation or escalation.
• Proficiency with administrative support tasks, electronic file maintenance, and claims-related tracking tools.