Carrier Senior Claims Oversight Analyst

Independence Pet Group; United States; A distancia; USD 74.000 - 93.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Healthcare

Parental Leave

Disability Insurance

PTO

Wellness Day

Descripción de la vacante

Independence American Insurance Company (IAIC) seeks a Senior Carrier Operations Claims Analyst to provide oversight of delegated claims and serve as a subject matter expert on complex claims and coverage interpretation. The role partners with TPAs and internal stakeholders to ensure compliant outcomes.

The position focuses on governance, audits, and process improvements across delegated claims operations, with remote work options within the United States.

Formación

• 5+ years of insurance claims, claims operations, compliance, quality, or related experience.
• Strong knowledge of claims handling, coverage interpretation, and regulatory requirements.
• Excellent analytical, problem-solving, communication, and stakeholder management skills.

Responsabilidades

• Oversee delegated claims operations and provide governance for complex claims.
• Evaluate coverage determinations, appeals, and escalated claim matters.
• Monitor administrator compliance with carrier requirements and regulatory guidelines.
• Support audits, fraud investigations, and risk mitigation initiatives.

Conocimientos

Analytical thinking

Problem solving

Communication

Stakeholder management

Educación

Bachelor's degree in Business, Insurance, Risk Management, or related field

Descripción del empleo

## Carrier Senior Claims Oversight AnalystApply: Remote: Default\\_Location: Full time: Posted 2 Days Ago: JR103090Established in 2021, **Independence Pet Holdings** is a corporate holding company that manages a diverse and broad portfolio of modern pet health brands and services, including insurance, pet education, lost recovery services, and more throughout North America. We believe pet insurance is more than a financial product and build solutions to simplify the pet parenting journey and help improve the well-being of pets. As a leading authority in the pet category, we operate with a full stack of resources, capital, and services to support pet parents. Our multi-brand and omni-channel approach include our own insurance carrier, insurance brands and partner brands. **Independence American Insurance Company (IAIC) is hiring for a Senior Carrier Operations Claims Analyst** **This is a fully remote role based in the United States** **Position Summary**The Senior Carrier Operations Claims Analyst (Carrier Operations Quality Claims Senior Analyst) provides oversight of delegated claims operations and serves as a subject matter expert for complex claims, coverage interpretation, appeals, and escalated claim matters. This role partners with internal stakeholders and third-party administrators to ensure claims are handled consistently, compliantly, and in accordance with carrier guidelines. **Key Responsibilities** **Claims Oversight & Governance*** Review and provide recommendations on high-dollar, complex, and over-authority claims.* Evaluate coverage determinations, appeals, exceptions, and other escalated claim matters.* Identify claim trends, operational risks, and opportunities for improvement across administrator partners. **Carrier Oversight*** Support audits, market conduct examinations, regulatory inquiries, and corrective action initiatives.* Monitor administrator compliance with carrier requirements, policies, and regulations.* Assist with fraud-related investigations, reporting, and risk mitigation activities. **Operational Excellence*** Analyze claims data, audits, and operational metrics to improve performance and outcomes.* Review administrator workflows, procedures, and controls for effectiveness and compliance.* Partner with stakeholders to implement process improvements and corrective action plans. **Documentation & Program Support*** Develop and maintain claims guidelines, governance standards, and operational procedures.* Support ongoing enhancements to claims oversight and governance programs.* Communicate policy updates, claims guidance, and operational requirements to stakeholders. **Leadership & Collaboration*** Serve as a subject matter expert for claims oversight and delegated claims administration.* Provide guidance, training, and support to team members and business partners.* Participate in projects and initiatives that strengthen carrier operations and claims governance. **Qualifications** **Required*** 5+ years of insurance claims, claims operations, compliance, quality, or related experience.* Strong knowledge of claims handling, coverage interpretation, and regulatory requirements.* Excellent analytical, problem-solving, communication, and stakeholder management skills. **Preferred*** Experience working with TPAs, delegated authority programs, or carrier oversight functions.* Experience supporting audits, compliance initiatives, fraud investigations, or process improvements.* Bachelor’s degree in Business, Insurance, Risk Management, or a related field. **Core Competencies*** Claims Oversight & Governance* Regulatory Compliance & Risk Management* Coverage Analysis & Problem Solving* Process Improvement & Operational Excellence* Communication & Business Partnership**Why Join IAIC** Join a growing carrier organization where you will play a key role in strengthening claims governance, improving operational effectiveness, and ensuring high-quality outcomes across delegated claims operations. CompensationBase pay range: $74,122 – $92,653 per year. This is the range we reasonably expect to pay at hire. Placement within the range depends on job-related factors such as experience, skills, and certifications.Base pay is one part of a total rewards package that includes the benefits listed below.All of our jobs come with great benefits including healthcare, parental leave and opportunities for career advancements. Some offerings are dependent upon the location of where you work and can include the following:* Comprehensive full medical, dental and vision Insurance* Basic Life Insurance at no cost to the employee* Company paid short-term and long-term disability* 12 weeks of 100% paid Parental Leave* Health Savings Account (HSA)* Flexible Spending Accounts (FSA)* Retirement savings plan* Personal Paid Time Off* Paid holidays and company-wide Wellness Day off* Paid time off to volunteer at nonprofit organizations* Pet friendly office environment* Commuter Benefits* Group Pet Insurance* On the job training and skills development* Employee Assistance Program (EAP)