Remote Claims Examiner – Growth & Impact

Transamerica; Oregon; Hybrid; USD 42,000 - 48,000; Full time

Benefits offered by this job

Pension Plan

401k Match

Medical Insurance

Dental Insurance

Vision Insurance

Paid Time Off

Tuition Reimbursement

Employee Discounts

Job summary

Transamerica is seeking a Claims Analyst to evaluate and analyze documentation for claim payments or denials per policy provisions and state regulations. This remote (call center) role involves reviewing claims, communicating with claimants and providers, and ensuring regulatory compliance.

The position offers a robust benefits package and potential annual bonus. The ideal candidate has an Associate’s degree in business or equivalent, two years of claims experience, and strong communication,

Qualifications

• Associate’s degree in a business field or equivalent experience
• Two years of claims experience
• Good understanding of life and annuity product language and provisions, and regulatory/compliance rules and regulations.
• Excellent communication and customer service skills
• Organizational, problem-solving and analytical skills
• Ability to cross train and learn other products
• Ability to multi-task and adapt to change

Responsibilities

• Under general supervision, analyze information/documentation received to determine how to proceed with a review of a claim and determine methods of obtaining additional information from alternative sources.
• Review claims and outside sources used in the review.
• Document correspondence and conversations.
• Correspond verbally and in writing with claimants, medical providers, medical examiners, and law enforcement.
• Work closely with department manager, legal counsel, medical director, claims assistants, and other departments to gather information for contested claims.
• Monitor claims for fraud and proceed according to each situation, such as engaging the Fraud team or additional research.
• Maintain compliance with regulations.

Skills

Communication skills

Customer service

Analytical thinking

Organizational skills

Problem solving

Multi-tasking

Education

Associate's degree in business or equivalent

Job description

Transamerica is seeking a Claims Analyst to evaluate and analyze documentation for claim payments or denials per policy provisions and state regulations. This remote (call center) role involves reviewing claims, communicating with claimants and providers, and ensuring regulatory compliance.

The position offers a robust benefits package and potential annual bonus. The ideal candidate has an Associate’s degree in business or equivalent, two years of claims experience, and strong communication,