Claims Analyst IV- Accident & Health

Confirm coverage of claims by reviewing policies and documents submitted in support of claims. Analyze coverage and communicate coverage position. Conduct, coordinate, and direct investigation into loss facts. Determine eligibility of claims and amounts owed under the terms of the contract. Recognize and pursue subrogation where warranted. Recognize and make appropriate Risk and Fraud referrals. Assist with team development and guidance. Assist manager with customer escalations and file audits as needed. Innovative mindset to help drive process improvement.

• Confirm coverage of claims by reviewing policies and documents submitted in support of claims.
• Analyze coverage and communicate coverage position.
• Conduct, coordinate, and direct investigation into loss facts.
• Determine eligibility of claims and amounts owed under the terms of the contract.
• Recognize and pursue subrogation where warranted.
• Recognize and make appropriate Risk and Fraud referrals.
• Assist with team development and guidance.
• Assist manager with customer escalations and file audits as needed.
• Innovative mindset to help drive process improvement.

• A highly organized individual with ability to work in a high pace, team oriented environment.
• Insurance claims experience of at least 7+ year(s) with exposure to large loss Accident and Health claims, which include sickness and bodily type injury claims or any related experience handling complex risks.
• Superior customer services skills and ability to help manage response timelines and reporting requirements, such as under performance guarantees
• Above average computer and organizational skills
• Excellent written and verbal communication skills with an ability to handle customer appeals.
• Ability to read and interpret insurance policies and act as liaison with Underwriting as needed.
• Ability to coach and develop others.
• Accident and Health State Adjuster licenses a plus, and job contingent after hire.
• Bilingual (Spanish) a plus

• Confirm coverage of claims by reviewing policies and documents submitted in support of claims.
• Analyze coverage and communicate coverage position.
• Conduct, coordinate, and direct investigation into loss facts.
• Determine eligibility of claims and amounts owed under the terms of the contract.
• Recognize and pursue subrogation where warranted.
• Recognize and make appropriate Risk and Fraud referrals.
• Assist with team development and guidance.
• Assist manager with customer escalations and file audits as needed.
• Innovative mindset to help drive process improvement.

At AIG, we are reimagining the way we help customers to manage risk. Join us as a Claims Examiner IV, Accident & Health to play your part in that transformation. It’s an opportunity to grow your skills and experience as a valued member of the team. Make your mark in Accident and Health Claims Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported by consistent processes and leadership, we take pride in delivering responsive, fair and professional service with empathy and efficiency.