Claims Examiner

Allianz

. Review submitted claims to identify incidents, determine applicable coverage based on policy terms, and calculate eligible reimbursement benefits .

Posted 10/27/2026full-timeRemote • United StatesMid-LevelSenior💰 $33,516 - $49,157 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in claims processing, including reviewing claims, determining coverage, and communicating outcomes effectively. Proficient in utilizing PeopleSoft and adhering to data governance and ethical standards while leveraging AI and data analytics tools.

Highest-signal resume keywords

Claims ProcessingPeopleSoftData AnalyticsAI UtilizationCommunication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ReviewCoverage DeterminationReimbursement CalculationDocumentationInvestigation of Claims

Soft Skills

Attention to DetailOrganizational SkillsTeam CollaborationIndependent WorkDesire to Learn

Tools & Technologies

PeopleSoftAI ToolsMachine LearningCloud-Based ToolsData Governance Standards

Industry Keywords

Claims ManagementInsurance AgreementCustomer CommunicationEthical Use StandardsVirginiaFlorida

Tech Stack

Tools & technologies

Cloud

About the role

Key responsibilities & impact

Review submitted claims to identify incidents, determine applicable coverage based on policy terms, and calculate eligible reimbursement benefits
Approve or deny claims according to insurance agreement terms and conditions
Communicate claim outcomes to customers by letter, email, or phone
Respond to customer inquiries about claim status, documentation, or general information
Document claim determinations, notes, and actions in PeopleSoft
Collaborate with internal departments to obtain or verify missing or unclear claim information
Investigate inconsistencies and escalate complex or questionable claims to the Team Leader
Send claim forms to new customers as needed
Work effectively with AI, machine learning, data analytics, and cloud-based tools while following data governance, security, and ethical-use standards

Requirements

What you’ll need

High school diploma or equivalent required
Strong desire to learn, grow, and build a long-term career
Strong attention to detail and solid organizational skills
Excellent written and verbal communication abilities
Ability to work independently and collaboratively within a team environment
Candidates must reside in either Virginia or Florida
Previous claims processing experience is a plus but not required
Familiarity with PeopleSoft or similar claims management systems is a plus
Responsible use of AI, machine learning, data analytics, and cloud-based tools in accordance with data governance, security, and ethical-use standards

Benefits

Comp & perks

Performance-based bonuses
Merit increases
Other incentives based on individual and company performance
Personal and professional development courses
Targeted development programs
International mobility and career progression opportunities
Work Well programs
Flexible work-life balance arrangements
Health insurance
Dental insurance
Vision insurance
Retirement savings plans
Paid time off
Other employee programs