Hybrid Claims Examiner: Analytical, Customer-Focused

Securian Financial Group; United States; Hybrid; USD 26,000 - 45,000; Full time

Benefits offered by this job

PTO

Company holidays

Health insurance

401(k) plan

Pension program

Job summary

Securian Financial Group is seeking a Claims Examiner to investigate, evaluate, and adjudicate claims while balancing accuracy, timeliness, compliance, risk, and customer experience.

Ideal candidates are analytical, detail-oriented, and able to communicate effectively using multiple channels. The role offers a hybrid work arrangement with priority on thoughtful, high-quality service to customers and beneficiaries.

Qualifications

• 2+ years of customer service experience.
• Strong analytical and problem-solving skills.
• Excellent attention to detail and organizational skills.
• Strong written and verbal communication skills.
• Demonstrated ability to make sound decisions and manage multiple priorities.
• Ability to learn and adapt to new and/or changing technologies and processes.
• Commitment to providing a high-quality customer experience.

Responsibilities

• Investigate, evaluate, and adjudicate claims in accordance with policy provisions, regulatory requirements, and company guidelines.
• Analyze claim information to determine coverage eligibility, benefit amounts, beneficiary entitlement, and claim validity.
• Gather and review information from customers, beneficiaries, employers, healthcare providers, funeral homes, and other internal and external partners.
• Communicate claim requirements, status updates, decisions, and next steps in a clear, timely, and professional manner.
• Proactively utilize phone, email, and written correspondence to support customers and facilitate timely claim resolution.
• Recognize opportunities where a direct conversation can improve understanding, reduce customer effort, and create a more positive customer experience.
• Maintain thorough claim records that support quality reviews, audits, regulatory requirements, and potential litigation.
• Ensure claim decisions, documentation, and payments are accurate, complete, and compliant.
• Partner with legal, medical, and investigative resources when additional expertise is needed.
• Contribute to process improvements, team initiatives, and special projects as assigned.
• Support workload continuity by assuming responsibility for in-progress claims during team transitions, ensuring uninterrupted service for customers.

Skills

Customer service

Analytical skills

Attention to detail

Communication skills

Decision making

Learning new tech

Customer experience

Tools

MS Outlook

MS Word

MS Excel

Job description

Securian Financial Group is seeking a Claims Examiner to investigate, evaluate, and adjudicate claims while balancing accuracy, timeliness, compliance, risk, and customer experience.

Ideal candidates are analytical, detail-oriented, and able to communicate effectively using multiple channels. The role offers a hybrid work arrangement with priority on thoughtful, high-quality service to customers and beneficiaries.