Senior Claims Examiner, Life & Disability (Hybrid)

The-Sovereign-General-Insurance-Company; New Jersey; Hybrid; USD 54,000 - 65,000; Full time

Benefits offered by this job

Paid time off

Training and development

Volunteer days

Total rewards package

Job summary

CUMIS Union is seeking a Claims Examiner III in a hybrid role based in Canada. You will adjudicate creditor life and disability claims, build case management plans, and determine claim eligibility while handling complex portfolios over $50,000 in coverage.

You will review medical information, interview claimants and employers, and communicate decisions. A post-secondary diploma and LOMA credentials are required, with development opportunities and comprehensive benefits.

Qualifications

• Completion of a post-secondary diploma with 2 years customer service experience.
• 2 years disability claims management experience preferred.
• Completion of LOMA 280 & 290 required.
• ALHC, degree in a related discipline preferred.
• Knowledge of creditor products.

Responsibilities

• Review current and historical medical information to assess misrepresentation in applications.
• Communicate rescission decisions to policyholders and parties.
• Ensure accuracy of information supporting a new claim.
• Interview claimants, employers, or loan officers by telephone.
• Determine claim payability and develop case management plans to minimize disability duration.
• Initiate assessments and examinations when necessary.
• Review claims for changes in definition and occupations.

Skills

Customer service

Communication skills

Team player

Adapt to change

Education

Post-secondary diploma

LOMA 280 & 290

Tools

LOMA 280

LOMA 290

Job description

CUMIS Union is seeking a Claims Examiner III in a hybrid role based in Canada. You will adjudicate creditor life and disability claims, build case management plans, and determine claim eligibility while handling complex portfolios over $50,000 in coverage.

You will review medical information, interview claimants and employers, and communicate decisions. A post-secondary diploma and LOMA credentials are required, with development opportunities and comprehensive benefits.