Senior Claims Examiner

Role Overview

• Build and maintain trusting, professional relationships across teams.
• Collaborate with internal departments to verify or obtain missing claim information.
• Continuously learn from experiences and apply feedback for ongoing improvement.
• Accurately process both core and complex claims with a focus on quality and efficiency.
• Serve as a subject matter expert, providing technical support and guidance to peers.
• Investigate and resolve claim discrepancies; escalate unresolved or questionable claims to the Manager.
• Act as a resource for less experienced associates, offering mentorship and support.
• Participate in cross-training efforts and provide support to cross-functional teams as needed.
• Assist with coaching and development initiatives within the team.
• Contribute to the training of new hires.
• 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.
• Proactively monitor and manage inventory to ensure timely processing and avoid backlogs.
• Act as a point of escalation for complex queries, ensuring swift and accurate resolution.
• Provide quick and focused training on specialty-based work types to upskill team members.
• Handle critical escalation calls and claims to ensure high-quality service delivery.
• Collaborate with the onshore team to align processes and maintain consistency, as this approach mirrors the successful model implemented for the US team.

Requirements

• Sound experience in a US Travel claims adjudication.
• Possess problem solving, interpersonal and phone etiquette skills.
• Possess excellent claim processing, customer service skills, a strong customer focus, and commitment to customer satisfaction.
• Excellent leadership and motivational skills required including demonstrated ability to coach and provide feedback to others.

Tech Stack

• Cloud
• Swift

Benefits

• Health insurance
• 401(k) matching
• Flexible work hours
• Paid time off
• Remote work options