Remote Senior Carrier Claims Governance Analyst

Independence Pet Group; United States; Remote; USD 74,000 - 93,000; Full time

Benefits offered by this job

Healthcare

Parental Leave

Disability Insurance

HSA/FSA

Retirement Plan

Paid Time Off

Wellness Day

Pet-Friendly Office

Commuter Benefits

Group Pet Insurance

Job summary

Independence American Insurance Company (IAIC) in the United States is seeking a Senior Carrier Operations Claims Analyst to oversee delegated claims operations and serve as a subject matter expert for complex claims, coverage interpretations, and appeals.

You will partner with internal teams and third-party administrators to ensure compliant handling, and you will lead governance, audits, and process improvements across carrier operations.

Qualifications

• 5+ years of insurance claims or related experience.
• Strong knowledge of claims handling, coverage interpretation, and regulatory requirements.
• Excellent analytical, problem-solving, communication, and stakeholder management skills.

Responsibilities

• Review high-dollar, complex, and over-authority claims.
• Evaluate coverage determinations, appeals, and escalated claims.
• Identify claim trends and risks across administrator partners.
• Support audits, regulatory inquiries, and corrective actions.
• Monitor administrator compliance with carrier requirements and regulations.
• Assist with fraud investigations, reporting, and risk mitigation.
• Analyze claims data and operational metrics to improve performance.
• Review workflows and controls for effectiveness and compliance.
• Collaborate to implement process improvements and corrective action plans.
• Develop and maintain claims guidelines and governance standards.
• Communicate policy updates and operational requirements to stakeholders.
• Provide guidance and training to team members and partners.
• Participate in projects strengthening carrier operations and governance.

Skills

Insurance claims

Claims operations

Regulatory knowledge

Analytical skills

Communication

Education

Bachelor’s degree in Business, Insurance, Risk Management, or related field

Job description

Independence American Insurance Company (IAIC) in the United States is seeking a Senior Carrier Operations Claims Analyst to oversee delegated claims operations and serve as a subject matter expert for complex claims, coverage interpretations, and appeals.

You will partner with internal teams and third-party administrators to ensure compliant handling, and you will lead governance, audits, and process improvements across carrier operations.