Claims Examiner

Claims Examiner Location: Fort Worth, TX Apply Job Number R2610-52913 Date posted 10/20/2026

The Claims Examiner position is responsible for evaluating and processing claims by performing all functions required to determine whether a claim is payable, deferred, or declined. This position ensures claims are handled in accordance with policy provisions, regulatory requirements, and company guidelines, while providing timely and professional correspondence to internal and external customers.

In the Role

Evaluate claims against eligibility requirements, provisions and applicable processes

Enter and maintain accurate data in claims processing systems, including written correspondence

Research and gather additional information to support claim decisions

Perform benefit calculations and conduct claim investigations

Communicate with internal and external customers via phone and written correspondence

Maintain positive customer relationships through professional and empathetic interactions

Participate in departmental meetings, training activities, and continuous improvement initiatives

Support occasional special projects and other duties as assigned

Requirements

High School diploma or equivalent required

Minimum 2+ year of general work experience

Strong analytical and problem-solving skills with attention to detail

Ability to evaluate claims against eligibility requirements and interpret policy language

Effective verbal and written communication skills

Basic math skills and proficiency in a PC environment, including Microsoft Office

Ability to build and maintain positive customer relationships

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