Carrier Senior Claims Oversight Analyst

Independence Pet Group; United States; Remote; USD 74,000 - 93,000; Full time

Benefits offered by this job

Healthcare

Parental Leave

Disability Insurance

HSA/FSA

Retirement Plan

Paid Time Off

Wellness Day

Pet-Friendly Office

Commuter Benefits

Group Pet Insurance

Job summary

Independence American Insurance Company (IAIC) in the United States is seeking a Senior Carrier Operations Claims Analyst to oversee delegated claims operations and serve as a subject matter expert for complex claims, coverage interpretations, and appeals.

You will partner with internal teams and third-party administrators to ensure compliant handling, and you will lead governance, audits, and process improvements across carrier operations.

Qualifications

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

Responsibilities

• Review high-dollar, complex, and over-authority claims.
• Evaluate coverage determinations, appeals, and escalated claims.
• Identify claim trends and risks across administrator partners.
• Support audits, regulatory inquiries, and corrective actions.
• Monitor administrator compliance with carrier requirements and regulations.
• Assist with fraud investigations, reporting, and risk mitigation.
• Analyze claims data and operational metrics to improve performance.
• Review workflows and controls for effectiveness and compliance.
• Collaborate to implement process improvements and corrective action plans.
• Develop and maintain claims guidelines and governance standards.
• Communicate policy updates and operational requirements to stakeholders.
• Provide guidance and training to team members and partners.
• Participate in projects strengthening carrier operations and governance.

Skills

Insurance claims

Claims operations

Regulatory knowledge

Analytical skills

Communication

Education

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

Job description

Established 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.

Compensation

Base 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)

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