Claims Examiner

myhrhome; Fort Worth (TX); On-site; USD 42,000 - 66,000; Full time

Job summary

OneMain Holdings, Inc. seeks a Claims Examiner to evaluate and process claims by applying policy provisions, regulations, and company guidelines. You will determine payable, deferred, or declined statuses and provide timely, professional correspondence to customers.

The role emphasizes data accuracy, research to support decisions, benefit calculations, and collaboration with internal teams. Strong analytical, math, and communication skills are essential, as is building positive relationships

Qualifications

• High School diploma or equivalent required.
• Minimum 2+ years of general work experience.
• Strong analytical and problem-solving skills with attention to detail.
• Ability to evaluate claims against eligibility requirements and interpret policy language.
• Effective verbal and written communication skills.
• Basic math skills and proficiency in a PC environment, including Microsoft Office.
• Ability to build and maintain positive customer relationships.

Responsibilities

• Evaluate claims against eligibility requirements, provisions and applicable processes.
• Enter and maintain accurate data in claims processing systems, including written correspondence.
• Research and gather additional information to support claim decisions.
• Perform benefit calculations and conduct claim investigations.
• Communicate with internal and external customers via phone and written correspondence.
• Maintain positive customer relationships through professional and empathetic interactions.
• Participate in departmental meetings, training activities, and continuous improvement initiatives.
• Support occasional special projects and other duties as assigned.

Skills

Analytical thinking

Problem-solving

Verbal & written communication

Attention to detail

Customer relations

Education

High School diploma or equivalent

Tools

Microsoft Office

Data entry

Job description

The Claims Examiner position is responsible for evaluating and processing claims by performing all functions required to determine whether a claim is payable, deferred, or declined. This position ensures claims are handled in accordance with policy provisions, regulatory requirements, and company guidelines, while providing timely and professional correspondence to internal and external customers.

In the Role

• Evaluate claims against eligibility requirements, provisions and applicable processes
• Enter and maintain accurate data in claims processing systems, including written correspondence
• Research and gather additional information to support claim decisions
• Perform benefit calculations and conduct claim investigations
• Communicate with internal and external customers via phone and written correspondence
• Maintain positive customer relationships through professional and empathetic interactions
• Participate in departmental meetings, training activities, and continuous improvement initiatives
• Support occasional special projects and other duties as assigned

Requirements

• High School diploma or equivalent required
• Minimum 2+ year of general work experience
• Strong analytical and problem-solving skills with attention to detail
• Ability to evaluate claims against eligibility requirements and interpret policy language
• Effective verbal and written communication skills
• Basic math skills and proficiency in a PC environment, including Microsoft Office
• Ability to build and maintain positive customer relationships

OneMain Holdings, Inc. is an Equal Employment Opportunity (EEO) employer. Qualified applicants will receive consideration for employment without regard to age, ancestry, citizenship status, color, creed, culture, disability, ethnicity, gender, gender identity or expression, genetic information or history, marital status, military status, national origin, nationality, pregnancy, race, religion, sex, sexual orientation, socioeconomic status, transgender or on any other basis protected by law.