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Penn Mutual · 15 hours ago

Sr Claims Examiner II

United States

Full-time

Remote

Mid, Senior Level

$65K/yr - $75K/yr

5+ years exp

Penn Mutual has been empowering individuals, families, and businesses for over 175 years. The Sr Claims Examiner II is responsible for handling highly complex and sensitive claims within Life, Annuity, and RPS, providing leadership in process improvements and mentoring junior examiners.

Financial ServicesInsurance

Responsibilities

Independently adjudicate highly complex life, annuity, and/or RPS death claims, ensuring compliance with all regulatory and contractual requirements

Exercise sound judgement and utilize appropriate medical and risk resources, adhering to referral policies, and transferring claims to appropriate risk level in timely manner

Demonstrate strong relationship building, customer service and communication when interacting with customers and business partners

Serve as an escalation point for unusual or disputed cases, providing expert analysis and resolution

Lead investigations into complex claims and collaborate with legal, compliance, and other departments as needed

Mentor and provide technical guidance to Sr Claims Examiner I and other team members

Identify and implement process improvements to enhance efficiency and accuracy

Represent the claims function in cross-functional projects and initiatives

Adheres to Service Level Agreements (SLAs) and individual/team metrics

Ability to work core business hours between 8:30 AM to 6:00 PM EST

Qualification

Life insurance expertiseClaims processes knowledgeAdvanced analytical skillsLeadership capabilitiesRisk managementClaims systems proficiencyCustomer service mindsetProcess improvementAI tools implementationMentoring skillsDetail orientedCommunication skills