Claims Examiner - AI-Driven Service & Growth

Allianz Popular SL.; Richmond (VA); On-site; USD 22,000 - 31,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Retirement plan

Paid time off

Performance bonuses

Job summary

Allianz Partners in the United States is seeking a Claims Examiner to review submissions, determine coverage, and calculate benefits for reimbursement. You will communicate outcomes to customers and document decisions in our systems, ensuring timely, accurate decisions in a dynamic environment.

We value a high school diploma, a strong desire to learn, and the ability to work independently or with a team. Familiarity with PeopleSoft is a plus.

Qualifications

• High school diploma or equivalent required.
• Strong desire to learn, grow, and build a long-term career.
• Previous claims processing experience is a plus but not required.
• Strong attention to detail and solid organizational skills.
• Excellent written and verbal communication abilities.
• Ability to work both independently and collaboratively within a team.
• Familiarity with PeopleSoft or similar claims management systems is a plus.
• Candidates must reside in either Virginia or Florida to be considered.

Responsibilities

• Review submitted claims to identify the incident, determine applicable coverage based on policy terms, and calculate eligible benefits for reimbursement.
• Approve or deny claims in accordance with the terms and conditions of the insurance agreement.
• Communicate claim outcomes to customers via letter, email, or phone once a decision has been reached.
• Respond to incoming customer inquiries regarding claim status, documentation, or general information.
• Accurately document claim determinations, notes, and actions in PeopleSoft following established guidelines.
• Collaborate with internal departments to obtain or verify missing or unclear claim information.
• Investigate inconsistencies and elevate complex or questionable claims to the Team Leader.
• Send out claim forms to new customers as needed.
• Work effectively in an environment shaped by AI, ML, data analytics and cloud-based tools, using insights responsibly with our data governance standards.

Skills

Attention to detail

Communication skills

Teamwork

Learning mindset

Independent work

Education

High school diploma or equivalent

Tools

PeopleSoft

Job description

Allianz Partners in the United States is seeking a Claims Examiner to review submissions, determine coverage, and calculate benefits for reimbursement. You will communicate outcomes to customers and document decisions in our systems, ensuring timely, accurate decisions in a dynamic environment.

We value a high school diploma, a strong desire to learn, and the ability to work independently or with a team. Familiarity with PeopleSoft is a plus.