Claims Examiner

Investigate and evaluate claims by applying critical thinking and problem-solving skills to determine appropriate claim outcomes. Review claim documentation for completeness, accuracy, and compliance with policy requirements. Communicate claim status updates to internal stakeholders and customers throughout the claims process. Analyze investigation findings and authorize claim payments or determine claim denials based on policy provisions. Ensure all required documentation is complete and properly maintained within each claim file. Manage a high-volume workload while consistently meeting established service level agreements and turnaround times. Respond to inbound inquiries regarding claim status, policy coverage, and benefit provisions. Maintain a high level of accuracy, professionalism, and customer service in all interactions. Adapt to changing priorities, business needs, and technology in a dynamic work environment. Qualifications Experience with living benefits claims processing preferred. Strong analytical, investigative, and decision‑making skills. Exceptional attention to detail and accuracy. Excellent written and verbal communication skills. Strong organizational and time management abilities. Ability to prioritize multiple tasks in a high‑volume environment. Positive, empathetic, and customer‑focused approach. Proven ability to work independently while contributing effectively within a team. Comfortable learning new systems and adapting to evolving technologies. Commitment to providing world‑class customer service and delivering high‑quality results. PrideGlobal and it's affiliates offers eligible employee's comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, pet insurance and employee discounts with preferred vendors #J-18808-Ljbffr Russell Tobin