Sr Claims Examiner

WoodmenLife is looking for a Sr Claims Examiner to join our team!

We are currently searching for a Sr Claims Examiner to join our team. The Sr Claims Examiner is responsible for securing and analyzing claim information to determine the approval or denial of claims related to Life, Annuity and Cancer products and benefits. The role involves making informed claims decisions in accordance with the terms of the contract, performing detailed analysis and documentation of claim data to direct effective outcomes, and meeting risk management and regulatory requirements in accordance with WoodmenLife’s policies and practices. The Sr Claims Examiner communicates with claimants, beneficiaries, health providers or others to gather information and clarify details of the claims. The Sr Claims Examiner is responsible for the adjudication and payment of all types claims for life, annuity and health products.

This is a remote position.

WoodmenLife is one of the best places to work in Omaha with over 130 years of service. As a member of the WoodmenLife family, you’re joining others who share your commitment to family, community and country. Through WoodmenLife, you’ll have opportunities to give back locally and honor those who make an impact. As a not-for-profit life insurance company, we’ve been helping to protect the financial future of families, making a difference in hometowns across America since 1890. We offer a variety of benefits ranging from health, dental, vision, 401K, life insurance and much more. Apply today to learn more!


We are looking for someone to:
• Serves as back up to Complex Claim Examiner to include, but not limited to the following:
◦ Processes accidental death claims. Research to determine if additional reports or documentation about the accident are required and assumes that consideration is given to all benefits that an individual may entitled to under the Accidental Death Benefit Rider
◦ Processes Suicide Claims. Research to determine if additional reports or documentation are needed and assure if the certificate is outside the Suicide Exclusion Period.
Processes Homicide Claims (Investigates if the beneficiary) was involved in the death in any way.
◦ Rival Claimants-Identifies and corresponds on claims when more than one person is claiming the same proceeds. Consults with the Legal Department when necessary and follows the “complaint” guidelines established by WoodmenLife. Correspond with all parties on a regular basis until resolved. Communicate with the Legal Department through the interpleader process until the proceeds are paid.
• Audits and authorizes payment of claims worked by other examiners within their limits Level I -II Examiners.
• Upon demonstration of required skills and competencies, independent claim approval limits up to $500,000
• Reviews contestable claims for accuracy. Assists associates or sales representatives with difficult or unusual calls or claims situations, providing instruction and guidance.
• Assists with internal audits and external audits such E&Y or any state audits

We need someone who has:

Minimum Qualifications:
• High school diploma or equivalent education/work experience.
• Demonstrates knowledge of WoodmenLife products and knowledge of Core Operations systems, policies and procedures.
• Demonstrates in-depth problem-solving capabilities, including ability to detect discrepancies, trends and efficiencies needed.
• Ability to understand and then clearly communicate information and answers to Home Office associates and external customers.
• Ability to provide and receive constructive feedback.
• Ability to maintain confidentiality, sensitivity and professionalism.
• Ability to work well with others in a team environment.
• Ability to work with a high level of concentration and attention to detail.
• Prefer 5+ years previous experience in claims processing life and health preferred.
• Ability to use multiple resources to research and resolve customer complaints submitted by claimants and State Insurance Departments.


WoodmenLife offers a competitive compensation package and a comprehensive benefits package. More information about our benefits can be found at https://www.woodmenlife.org/careers/home-office/benefits/.
As part of WoodmenLife’s employment process, candidates will be required to complete a criminal background check, credit check (where required for position), Fingerprint check (where required for position), drug screen and reference checks. Any offer of employment will be contingent upon successfully passing the above.
WoodmenLife is welcoming to all regardless of background and beliefs. WoodmenLife respects every associate’s unique perspective and contribution. We are committed to creating an environment that values di