About the Role
Our client is seeking an experienced Insurance Claims Examiner to join their team in Oklahoma City, Oklahoma . This hybrid role involves reviewing and analyzing insurance claims to ensure accuracy, compliance, and fairness. The ideal candidate will possess a strong understanding of various insurance policies, claims handling procedures, and regulatory requirements. You will be responsible for investigating claim validity, determining coverage, calculating benefits, and authorizing payments. This position requires meticulous attention to detail and excellent analytical skills. Join a company committed to ethical practices and exceptional customer service.
Key Responsibilities Review submitted insurance claims for completeness, accuracy, and compliance with policy terms and conditions. Investigate claim details, verifying policy coverage and eligibility. Analyze supporting documentation, including medical records, police reports, and repair estimates. Determine the validity and extent of covered losses. Calculate and authorize payment of claims in accordance with policy limits and company guidelines. Communicate claim status and decisions clearly and professionally to policyholders, claimants, and agents. Identify potential fraudulent claims and escalate them for further investigation. Maintain accurate and detailed records of all claim activities in the claims management system. Ensure compliance with state and federal insurance regulations. Process endorsements, cancellations, and policy changes related to claims as needed. Requirements High school diploma or equivalent; Bachelor's degree preferred. Minimum of 3 years of experience as a Claims Examiner or Claims Adjuster. Strong knowledge of insurance policies (e.g., auto, home, life, health) and claims procedures. Proficiency in claims processing software and databases. Excellent analytical, investigative, and problem-solving skills. Strong attention to detail and accuracy. Effective written and verbal communication skills. Ability to manage a caseload and prioritize effectively in a hybrid work environment. Understanding of insurance regulations and compliance standards. Ability to work independently and collaboratively with a team in Oklahoma City, Oklahoma . Benefits
Our client offers a competitive salary, performance incentives, comprehensive health, dental, and vision insurance, a 401(k) savings plan with company match, paid time off, and opportunities for professional development and continuing education. Become part of a supportive team that values integrity and client satisfaction in Oklahoma City, Oklahoma .