Senior Claims Oversight Analyst

Independence Pet Group

. Review and provide recommendations on high-dollar, complex, and over-authority claims .

Posted 10/12/2026full-timeRemote • United StatesSenior💰 $74,122 - $92,653 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in insurance claims management, including claims handling, regulatory compliance, and operational improvement. Proficient in analyzing claims data and providing strategic recommendations to enhance performance and governance.

Highest-signal resume keywords

Claims HandlingRegulatory ComplianceAnalytical SkillsStakeholder ManagementFraud Investigations

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims OperationsCoverage InterpretationData AnalysisProcess ImprovementAudit Support

Soft Skills

Problem-SolvingCommunicationTeam Support

Industry Keywords

Insurance ClaimsOperational RisksGovernance StandardsDelegated Authority ProgramsMarket Conduct Examinations

About the role

Key responsibilities & impact

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

What you’ll need

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

Comp & perks

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)