Senior Claims Examiner at Ethos Life

, , United States -

Full Time

Start Date

Immediate

Expiry Date

13 Jan, 26

Salary

115000.0

Posted On

15 Oct, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Claims Examination, Life Insurance, Final Expense Claims, Contestable Claims, Independent Decision Making, Mentorship, Process Improvement, Investigation, Analytical Skills, Communication Skills, Attention to Detail, Salesforce, Regulatory Requirements, Fraud Detection, Operational Reporting, Technical Guidance

Industry

Insurance

Description

About Ethos Ethos was built to make it faster and easier to get life insurance for the next million families. Our approach blends industry expertise, technology, and the human touch to find you the right policy to protect your loved ones. We leverage deep technology and data science to streamline the life insurance process, making it more accessible and convenient. Using predictive analytics, we are able to transform a traditionally multi-week process into a modern digital experience for our users that can take just minutes! We’ve issued billions in coverage each month and eliminated the traditional barriers, ushering the industry into the modern age. Our full-stack technology platform is the backbone of family financial health. We make getting life insurance easier, faster and better for everyone. Our investors include General Catalyst, Sequoia Capital, Accel Partners, Google Ventures, SoftBank, and the investment vehicles of Jay-Z, Kevin Durant, Robert Downey Jr and others. This year, we were named on CB Insights' Global Insurtech 50 list and BuiltIn's Top 100 Midsize Companies in San Francisco. We are scaling quickly and looking for passionate people to protect the next million families! About the Role Creating a positive and differentiated customer experience is critical to Ethos’ mission and continues to drive our growth and success in the life insurance industry. We are looking for a Senior Claims Examiner to join our team and play a key role in adjudicating complex life insurance claims, with a focus on final expense and contestable claims. This senior level position combines independent decision making authority with leadership responsibilities, mentorship, and process improvement to ensure beneficiaries receive fair and timely outcomes. As a Senior Claims Examiner at Ethos, you will be responsible for leading the review and resolution of sensitive and complex life insurance claims. You will investigate contestability and misrepresentation issues, partner with legal, external investigators, underwriting, and carrier teams to ensure proper handling. You will serve as a subject matter expert (SME), mentoring associates, and contributing to operational and process enhancements. Success in this role requires deep claims expertise, a balance of empathy and risk management, and the ability to influence claims strategy. Duties and Responsibilities: Lead the adjudication of complex or contested life insurance claims Conduct thorough investigations of policy applications, death certificates, medical records, attending physician statements, and third-party reports Exercise independent settlement authority within defined limits and ensure fair, accurate claims decisions Identify contestability, misrepresentation, and fraud concerns, escalating to legal as needed Serve as a subject matter expert for life insurance claims, with a focus on final expense claims, contestable claims, and claims adjudication best practices Train and mentor associates, providing coaching and technical guidance on complex claims handling Collaborate with carriers, legal, claim investigators, underwriting, and internal partners to resolve escalated claims and ensure compliance Maintain the integrity of claims data across systems and prepare detailed, auditable claim files Proactively identifying risks and suggesting corrective actions to ensure goals are met Partner with product and technology teams to provide feedback on tooling enhancements that improve claims workflow efficiency Contribute to the development and implementation of claims process improvements and team wide best practices Qualifications and Skills: 5+ years of experience in life insurance claims examination or adjudication, with strong experience in final expense and contestable claims Proven ability to adjudicate complex claims and exercise independent settlement authority Strong understanding of life insurance products, exclusions, contestability periods, and regulatory requirements Experience leading, mentoring, or training claims examiners or associates Proficiency with Salesforce or equivalent CRM/claims management platforms Excellent written and verbal communication skills, with the ability to convey empathy and professionalism Strong analytical skills with the ability to evaluate medical records, policy applications, and supporting claim documentation Exceptional attention to detail, organization, and follow-through Demonstrated integrity in handling sensitive and confidential information Experience preparing operational or claims performance reports and presenting insights to leadership is strongly preferred Professional designations such as FLMI, or AIRC are a plus #LI-Remote The US national base salary range for this full-time position is $70,000 - $115,000. Our salary ranges are determined by role, level, and location. The range displayed on each job posting reflects the minimum and maximum target for new hire salaries for the position across all US locations. Within the range, individual pay is determined by work location and additional factors, including job-related skills, experience, and relevant education or training. Please note that the compensation details listed in US role postings reflect the base salary only and do not include applicable bonus, equity, or benefits. You can find further details of our US benefits at https://www.ethoslife.com/careers/ Don’t meet every single requirement? If you’re excited about this role but your past experience doesn’t align perfectly with every qualification in the job description, we encourage you to apply anyway. At Ethos we are dedicated to building a diverse, inclusive and authentic workplace. We are an equal opportunity employer who values diversity and inclusion and look for applicants who understand, embrace and thrive in a multicultural world. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Pursuant to the SF Fair Chance Ordinance, we will consider employment for qualified applicants with arrests and conviction records. To learn more about what information we collect and how it may be used, please refer to our California Candidate Privacy Notice. Don’t meet every single requirement? If you’re excited about this role but your past experience doesn’t align perfectly with every qualification in the job description, we encourage you to apply anyway. At Ethos we are dedicated to building a diverse, inclusive and authentic workplace. We are an equal opportunity employer who values diversity and inclusion and look for applicants who understand, embrace and thrive in a multicultural world. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Pursuant to the SF Fair Chance Ordinance, we will consider employment for qualified applicants with arrests and conviction records. To learn more about what information we collect and how it may be used, please refer to our California Candidate Privacy Notice. US Resident Assisted Automated Decision Making Notice

Responsibilities

The Senior Claims Examiner will lead the adjudication of complex life insurance claims, focusing on final expense and contestable claims. This role involves independent decision-making, mentoring associates, and collaborating with various teams to ensure fair and timely outcomes for beneficiaries.