Remote Claims Examiner - Impactful, Precise & Compassionate

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

Benefits offered by this job

Paid time off

Holidays

Health insurance

401(k) retirement plan

Volunteer time

Employee Resource Groups

Job summary

Securian Financial is seeking a detailed and analytical Claims Examiner to investigate, evaluate, and adjudicate claims with accuracy and compassion. You will gather information from customers, beneficiaries, providers, and partners, determine coverage eligibility, and communicate decisions clearly while ensuring compliance and quality service.

In this hybrid role based near St. Paul, MN, you will collaborate with legal, medical, and investigative resources, contribute to process improvements,

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.
• Knowledge of employer-sponsored life insurance, waiver of premium, accelerated death benefit, or related insurance products.
• Experience adjudicating insurance claims.
• Ability to navigate sensitive situations with empathy, professionalism, and strong judgement.
• Experience working in administrative, claims, or workflow management systems.
• Experience building positive relationships with customers, business partners, and other stakeholders.
• Proficiency with Microsoft Outlook, Word, and Excel.
• Curiosity and willingness to learn and leverage AI-enabled tools to improve efficiency, decision-making, and the 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 thinking

Detail oriented

Communication

Decision making

Adaptability

Customer experience

Insurance knowledge

Adjudication experience

Empathy

Stakeholder management

Curiosity about AI tools

Judgement

Tools

Microsoft Outlook

Microsoft Word

Microsoft Excel

Job description

Securian Financial is seeking a detailed and analytical Claims Examiner to investigate, evaluate, and adjudicate claims with accuracy and compassion. You will gather information from customers, beneficiaries, providers, and partners, determine coverage eligibility, and communicate decisions clearly while ensuring compliance and quality service.

In this hybrid role based near St. Paul, MN, you will collaborate with legal, medical, and investigative resources, contribute to process improvements,