[Remote] Claims Examiner
Note: The job is a remote job and is open to candidates in USA. Allianz Partners is a global leader in insurance and asset management, committed to putting people first. As a Claims Examiner, you will review claims, determine coverage, and communicate outcomes to customers, ensuring timely and accurate service.
Responsibilities
- Review submitted claims to identify the incident, determine applicable coverage based on policy terms, and calculate eligible benefits for reimbursement
- Approve or deny claims in accordance with the terms and conditions of the insurance agreement
- Communicate claim outcomes to customers via letter, email, or phone once a decision has been reached
- Respond to incoming customer inquiries (phone or email) regarding claim status, documentation, or general information
- Accurately document claim determinations, notes, and actions in PeopleSoft following established guidelines
- Collaborate with internal departments to obtain or verify missing or unclear claim information
- Investigate inconsistencies and escalate complex or questionable claims to the Team Leader
- Send out claim forms to new customers as needed
- Work effectively in an environment shaped by artificial intelligence (AI), machine learning, data analytics and cloud-based tools, using insights responsibly with our standards of data governance, security and ethical use
Skills
- High school diploma or equivalent required
- A strong desire to learn, grow, and build a long-term career with us
- Strong attention to detail and solid organizational skills
- Excellent written and verbal communication abilities
- Ability to work both independently and collaboratively within a team environment
- Previous claims processing experience is a plus but not required
- Familiarity with PeopleSoft or similar claims management systems is a plus
Benefits
- Health, dental, and vision insurance
- Retirement savings plans
- Paid time off
- Other employee programs
Company Overview
Company H1B Sponsorship