Senior Group Life Claims Examiner

Equitable

Senior Claims Examiner managing Life claims at Equitable. Ensuring accurate claims processing, customer satisfaction, and mentoring junior examiners.

Posted 6/10/2026full-timeNew York, North Carolina • 🇺🇸 United StatesSenior💰 $60,000 - $68,000 per yearWebsite

About the role

Key responsibilities & impact

Claims Management: Oversees end-to-end claims process. Responsible for active case management of Life claims. Ensures claims are processed accurately within regulatory and company guidelines. Deliver an exceptional customer experience and ensure that customer commitments and deliverables are achieved. Review and interpret medical records, utilizing resources as appropriate. Complete complex financial calculations specific to claims when applicable. Gain an understanding and working knowledge of the Equitable claim and other applicable systems, policies, procedures, and contracts as well as regulatory and statutory requirements for claim adjudication. Apply contract/policy provisions to ensure accurate eligibility and liability decisions. Demonstrate and apply analytical and critical thinking skills.
Client and Customer Relationships: Foster strong relationships with clients to understand their needs and ensure high levels of satisfaction. Addresses and resolves any customer challenges or concerns promptly. Communication via telephone, email, and text with employees, employers, attorneys, and others. Provide timely and exceptional customer experience by paying appropriate claims accurately and timely, responding to all inquiries and maintaining expected service and quality standards. Work within a fast-paced environment, with tight deadlines, and demonstrate the ability to balance multiple priorities. Work independently as well as within a team structure. Assist in training and mentoring junior claim examiners on best practices, improving their decision-making skills. Oversee the ongoing management of complex, high-priority or escalated cases and callers.

Requirements

What you’ll need

3+ years prior experience managing Life claim products
Excellent client relationship management skills
Strong verbal, written communication, and presentation skills
Comfortable dealing with complexity and ambiguity and able to explore multiple solutions
Previous experience with FINEOS Claims software platform highly desired
Exceptional customer service skills; Proven skills in positive and effective interaction with challenging customers
Strong knowledge of regulatory requirements for Life claims
Ability to handle sensitive information with confidentiality and professionalism
Strong written and oral communication skills demonstrated in previous work experience
Excellent organizational and time management skills with ability to multitask and prioritize deadlines
Ability to manage multiple and changing priorities
Detail oriented; able to analyze and research contract information
Demonstrated ability to operate with a sense of urgency
Experience in effectively meeting/exceeding individual professional expectations and team goals
Demonstrated analytical and math skills
Ability to exercise critical thinking skills, risk management skills and sound judgment
Ability to adapt, problem solve quickly and communicate effective solutions
High level of flexibility to adapt to the changing needs of the organization
Self-motivated, independent with proven ability to work effectively on a team and work with others in a highly collaborative team environment
Continuous improvement mindset
A commitment to support a work environment that fosters diversity and inclusion
Strong computer literacy and skills with the ability to work within multiple systems; proficiency with PC based programs such as Excel and Word.
Reliability and dependability throughout our extensive training program is crucial.

Benefits

Comp & perks

medical
dental
vision
401(k) plan
paid time off

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

claims managementfinancial calculationsanalytical skillsmath skillscontract analysisrisk managementcritical thinking

Soft Skills

client relationship managementcommunication skillscustomer serviceorganizational skillstime managementproblem solvingflexibilityself-motivatedteam collaborationcontinuous improvement mindset