About this role
Role Overview
- Investigating claims involving potential material misrepresentation
- Conducting thorough coverage and liability investigations
- Analyzing policy information, statements, and supporting documentation
- Drafting clear, well-supported coverage determination and denial letters
- Collaborating with internal partners for consistent claim resolutions
- Maintaining detailed documentation in accordance with regulatory and company guidelines
Requirements
- Solid background in claims handling with direct experience in coverage investigation and liability determination
- Demonstrated experience investigating policy fraud or material misrepresentation
- Ability to accurately interpret policy language and confidently communicate coverage decisions in writing
- High level of attention to detail
- Strong analytical skills and sound judgment
Benefits
- Equal Opportunity employer – Veterans/Disabled and other protected categories
- Health insurance
- 401(k)
- Paid time off
- Flexible work arrangements
- Professional development opportunities