Life Insurance Claims Operations Specialist

About the RoleWe are seeking a detail-oriented and experienced Process Specialist to join our Life Insurance Claims Operations team, supporting a Corporate-Owned Life Insurance (COLI) client. This role sits at the intersection of operational excellence and insurance domain expertise, and is ideal for a professional who thrives in a high-volume, compliance-driven environment.The successful candidate will bring 3-5 years of hands-on experience in life insurance claims processing, with demonstrated ability to manage complex transactions, resolve exceptions, and maintain quality standards across end-to-end workflows. Prior exposure to COLI claims is a strong differentiator.Key ResponsibilitiesPerform detailed review and validation of life insurance claims documentation, policy forms, and supporting evidence to ensure completeness, accuracy, and regulatory compliance.Process high-volume, detail-sensitive claims transactions across policy administration systems and workflow tools; research, validate, and resolve discrepancies efficiently.Identify and resolve NIGO (Not In Good Order) items, suspense cases, and pending exceptions while minimizing cycle times and rework.Apply working knowledge of state and federal insurance regulations, internal controls, and privacy standards throughout all claims processing activities.Maintain accurate and audit-ready case notes, documentation, and activity logs to support compliance reviews and client inquiries.Identify trends in errors or exceptions and escalate findings to leadership to drive continuous process improvement.Support UAT, post-release validation, and pilot initiatives for system or process enhancements.Assist with onboarding and knowledge transfer for new team members as needed.Provide back-up coverage across related operational functions and client accounts during peak volume periods.Required Qualifications3-5 years of experience in life insurance claims processing operations, with strong command of the end-to-end claims lifecycle.In-depth knowledge of life insurance products including policy lifecycle events: new business, policy changes, disbursements, claims, and regulatory requirements.Proficiency in navigating policy administration systems and workflow platforms in a production environment.Solid understanding of applicable state and federal insurance regulations, compliance checkpoints, and documentation standards.Strong analytical and problem-solving ability; capable of identifying root causes, resolving exceptions, and escalating appropriately.High attention to detail and accuracy with a track record of error-free processing in a regulated environment.Effective communicator with the ability to collaborate across functions including Compliance, Financial Services, and Contact Center teams.

Created: 2026-05-08