Claims Examiner

Davies
United States
Workplace: RemoteFull timeFunction: Insurance & ActuarialSkills: ["Analytical skills","Attention to detail","Communication","Collaboration","Stakeholder management"]

Review Stop Loss claims for multiple clients, maintaining key performance metrics while delivering accurate findings. Work within the Excess Claims Management unit to analyze claims, policies, and supporting documentation, then create recommendations through client claims systems and standardized reporting. Collaborate with clients and colleagues throughout the review process, manage client expectations, and produce documents and correspondence based on review and analysis.

Loading

Loading job details...

Preparing the role view and application actions.

FursaFursa
Davies
Davies
3 hours ago

Claims Examiner

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI
Last checked: 3 hours agoStatus: Live

Job Summary

Review Stop Loss claims for multiple clients, maintaining key performance metrics while delivering accurate findings. Work within the Excess Claims Management unit to analyze claims, policies, and supporting documentation, then create recommendations through client claims systems and standardized reporting. Collaborate with clients and colleagues throughout the review process, manage client expectations, and produce documents and correspondence based on review and analysis.
Location: United States
Workplace: Remote
Employment Type: Full time
Job Function: Insurance & Actuarial

Key Responsibilities

  • •Focus on Stop Loss claim reviews for multiple clients, maintaining key performance metrics.
  • •Analyze claims, policies, and supporting documentation and report findings to clients.
  • •Create reporting documents and correspondence based on review and analysis of data and policies.
  • •Deliver recommendations via client claims systems, standardized reporting, claimant worksheets, and cumulative bordereaux.
  • •Collaborate with clients and colleagues to support the review process and manage client expectations.

Pay and Benefits

Perks:PensionLife AssuranceEapDigital Gp

Key Requirements

  • •Experience within insurance, reinsurance, healthcare claims, or a claims administration environment.
  • •Strong analytical skills to review claims, policies, and supporting documentation accurately.
  • •Excellent attention to detail and commitment to delivering high-quality work within agreed service levels.
  • •Strong written and verbal communication skills, including liaising with clients and stakeholders.
  • •Proficiency in Microsoft Office (particularly Excel) and experience using claims management systems.
Experience:InsuranceReinsuranceHealthcare claimsClaims administration
Skills:Analytical skillsAttention to detailCommunicationCollaborationStakeholder management
Tech Stack:Microsoft OfficeExcelClaims management systems

Company Brief

Davies
Davies is a specialist professional services and technology firm delivering claims, underwriting, and risk solutions to insurers, reinsurers, brokers and regulated businesses globally, with major capabilities in claims management, forensics, and digital transformation.
Industry: Consulting
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Established Company
Valuation: Unicorn (USD 1B+)
Funding: Private Equity Backed
Headquarters: City of London, United Kingdom
Founded: 1968
Glassdoor
Glassdoor: 3.8
WebsiteLinkedInGlassdoor