Claims Examiner IV, Accident & Health

AIG - Shawnee, KS

Full-time - Mid Level

Shawnee, KS

Insurance Carriers and Related Activities

About the position

At AIG, we are reimagining the way we help customers manage risk. As a Claims Examiner III in Accident & Health, you will play a crucial role in this transformation. This position offers an opportunity to grow your skills and experience as a valued member of our team. Our Claims teams are recognized as the proven problem solvers for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience. We take pride in delivering responsive, fair, and professional service with empathy and efficiency, supported by a robust stakeholder feedback loop and consistent processes and leadership. As a Personal Accident Claim Examiner, you will be responsible for handling all aspects of claim resolution for assigned claims while providing world-class service to both external and internal customers. Your duties will include confirming coverage of claims by reviewing policies and documents submitted in support of complex claims, analyzing coverage, and communicating the coverage position. You will manage key stakeholders, including brokers, underwriting partners, and policyholders, while conducting, coordinating, and directing investigations into loss facts. Additionally, you will determine the eligibility of claims and amounts owed under the terms of the contract, recognize and pursue subrogation where warranted, and make appropriate Risk and Fraud referrals. You will handle high technical and severity losses with minimal supervision, including performance guarantee accounts and litigation, and manage Accidental Death & Dismemberment claims in a timely and accurate manner. Mentoring and guiding team members, assisting with stakeholder management, and participating in client stewardship meetings and customer escalations will also be part of your responsibilities. An innovative mindset to help drive process improvement is essential, along with the ability to read and interpret insurance policies and act as a liaison with Underwriting and legal counsel.

Responsibilities

• Handle all aspects of claim resolution for assigned claims.
• Confirm coverage of claims by reviewing policies and documents submitted in support of complex claims.
• Analyze coverage and communicate coverage position to key stakeholders.
• 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.
• Make appropriate Risk and Fraud referrals.
• Handle high technical and severity losses with minimal supervision.
• Manage Accidental Death & Dismemberment claims timely and accurately.
• Assist with team development and guidance, including mentoring and file audits.
• Assist manager with stakeholder management, such as client stewardship meetings and customer escalations.
• Drive process improvement with an innovative mindset.

Requirements

• At least 5+ years of insurance claims experience, specifically in Accident and Health claims.
• Exposure to sickness and bodily injury claims or related experience handling complex risks.
• Superior customer service skills and ability to manage response timelines and reporting requirements.
• Above average computer and organizational skills.
• Excellent written and verbal communication skills, with the 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 are a plus, contingent after hire.
• Bilingual (Spanish) is a plus.

Nice-to-haves

• Accident and Health State Adjuster licenses
• Bilingual (Spanish)

Benefits

• Comprehensive benefits package focused on health, wellbeing, and financial security.
• Professional development opportunities.
• Flexible work arrangements.
• Diversity and inclusion learning programs.
• Cultural awareness activities and Employee Resource Groups (ERGs).