Claims Specialist

Claims Specialist

We are seeking a compassionate, service-oriented Claims Specialist to join our team in Blue Ash, Ohio. In this role, you will serve as the primary point of contact for beneficiaries, funeral homes, and agents navigating the death claim process.

This position requires a balance of empathy, professionalism, strict attention to detail, and sound judgment. You will guide grieving families and business partners through a sensitive process while ensuring all claims are evaluated and disbursed accurately in accordance with policy provisions, internal procedures, and state regulations.

Client & Agent-Facing Support

• Serve as the first point of contact for death claim calls from agents, funeral homes, beneficiaries, and claimants, delivering clear and compassionate guidance.
• Calculate and quote death benefits, explain required documentation and next steps, and suspend policies immediately upon notice of death.
• Proactively follow up with claimants, beneficiaries, funeral homes, and agents to collect outstanding documentation and maintain continuous progress on pending claims.
• De-escalate frustrated or distressed callers with patience, empathy, professionalism, and structured communication.

Claims Processing & Administration

• Manage the end-to-end claims lifecycle: collect proofs of death, review policy terms, calculate and disburse payments, and manage pending files per state laws and company guidelines.
• Prepare complete, organized claim files containing policy applications, beneficiary details, proofs of death, correspondence, and supporting records.
• Complete Texas Reconciliation spreadsheets where applicable.
• Verify payment accuracy, document calculations, and prepare complete records for review and authorization.
• Update and terminate active policies in the policy administration system following claim approval and payout.
• Prepare, audit, and maintain digital imaged files to ensure strict compliance and audit-readiness.
• Maintain active tracking tools, checklists, and pending queues to support consistent, timely claim turns.

Research, Judgment & Escalation

• Conduct claim investigations when warranted; identify contestability or potential fraud concerns and formulate well-documented recommendations regarding policy rescission or executive escalation.
• Perform detailed policy research to resolve eligibility questions and support accurate claim determinations.
• Protect confidential claimant, beneficiary, policy, and financial data with high discretion in compliance with company privacy standards.

Qualifications & Skills

• Empathy & Composure: Genuine comfort handling emotionally difficult conversations while remaining calm, patient, and professional under pressure.
• Service Orientation: Strong commitment to responsiveness, consistent follow-through, and clear communication.
• Analytical Precision: High attention to detail and sound judgment regarding regulatory compliance, financial disbursement accuracy, and contestability reviews.
• Education: Associate's degree or equivalent practical work experience.
• Technical Skills: Working knowledge of Microsoft Office (especially Excel) and comfort adapting to policy administration software, digital imaging tools, and internal tracking systems.
• Communication: Exceptional verbal and written communication skills.
• Background (Plus): Prior experience in life insurance claims, insurance operations, or the funeral service industry is helpful but not required. LOMA matriculation or life insurance background is a strong plus. Process and systems are trainable for candidates who possess the right aptitude and service mindset.

Compensation / Pay Rate (Up to): $20.00 - $27.00