Senior Claims Oversight Analyst

Job not on LinkedIn

🔥 13 hours ago

🇺🇸 United States – Remote

💵 $74.1k - $92.7k / year

⏰ Full Time

🟠 Senior

🧐 Analyst

👻 Ghost score 0%

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Independence Pet Group

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🛡️ Insurance

👥 B2C

🧘 Wellness

Insurance • B2C • Wellness

Independence Pet Group is one of North America’s largest pet insurance and services organizations. The company supports insurance for more than 800,000 pets in the U. S. and Canada, with a mission to strengthen the bond between pets and their owners through innovative products and services. IPG offers a comprehensive range of underwriting options, turnkey partner solutions, and consumer-facing insurance products to support pets throughout their lives. The company is home to several insurance brands, providing vital support and services in the pet care industry.

📋 Description

• Review and provide recommendations on high-dollar, complex, and over-authority claims • Evaluate coverage determinations, appeals, exceptions, and escalated claim matters • Identify claim trends, operational risks, and improvement opportunities across administrator partners • Support audits, market conduct examinations, regulatory inquiries, and corrective action initiatives • Monitor administrator compliance with carrier requirements, policies, and regulations • Assist with fraud-related investigations, reporting, and risk mitigation activities • Analyze claims data, audits, and operational metrics to improve performance and outcomes • Review administrator workflows, procedures, and controls for effectiveness and compliance • Partner with stakeholders to implement process improvements and corrective action plans • Develop and maintain claims guidelines, governance standards, and operational procedures • Support enhancements to claims oversight and governance programs • Communicate policy updates, claims guidance, and operational requirements to stakeholders • Serve as a subject matter expert for claims oversight and delegated claims administration • Provide guidance, training, and support to team members and business partners • Participate in projects and initiatives that strengthen carrier operations and claims governance

🎯 Requirements

• 5+ years of insurance claims, claims operations, compliance, quality, or related experience • Strong knowledge of claims handling, coverage interpretation, and regulatory requirements • Excellent analytical, problem-solving, communication, and stakeholder management skills • Preferred: Experience working with TPAs, delegated authority programs, or carrier oversight functions • Preferred: Experience supporting audits, compliance initiatives, fraud investigations, or process improvements • Preferred: Bachelor’s degree in Business, Insurance, Risk Management, or a related field

🏖️ Benefits

• Comprehensive full medical, dental and vision Insurance • Basic Life Insurance at no cost to the employee • Company paid short-term and long-term disability • 12 weeks of 100% paid Parental Leave • Health Savings Account (HSA) • Flexible Spending Accounts (FSA) • Retirement savings plan • Personal Paid Time Off • Paid holidays and company-wide Wellness Day off • Paid time off to volunteer at nonprofit organizations • Pet friendly office environment • Commuter Benefits • Group Pet Insurance • On the job training and skills development • Employee Assistance Program (EAP)