Sr Associate, Claim Representative - Operations

This role ensures timely and accurate processing of claims, supports internal and external audits, and contributes to operational efficiency. The Sr. Associate works cross-functionally to resolve issues and maintain high standards of data integrity and client service.

• Perform adjudication of life claims for assigned clients, including standard and contestable cases.
• Review claim documentation such as death certificates, claimant statements, and policy records to verify eligibility.
• Assess claim validity based on treaty terms, policy provisions, and underwriting guidelines.
• Assist with performance of client adjudication audits for assigned clients to ensure compliance with treaty terms and adjudication standards.
• Serve as liaison to clients for claim-related inquiries
• Review and approve claims in accordance with claim payment approval hierarchy.
• Review, enhance, and sign settlements to ensure timely client payments
• Process claim refunds appropriately and timely.
• Monitor workflow and identify potential claims processing issues.
• Work cross-functionally to resolve system impediments to claim payment processing.
• Identify opportunities for improvement and contribute to process enhancements.
• Assist with internal and external audits and ensure all ICS controls are properly documented.
• Establish requirements for system enhancements and log tickets for tracking, testing, and implementation.
• Creation and maintenance of reports allowing for analysis of claim workflow and data fields to ensure accuracy of claim data.
• Analyze client trending data to understand financial results and identify potential future impact.
• Produce ad-hoc reports and claims metrics for management and other stakeholders.
• Perform monthly and quarterly reporting requirements for performance measurement and to meet quarter end deliverables.
• May perform other duties as required.

• BA/BS degree in business administration with an emphasis in accounting/finance or equivalent work experience
• Advanced degree or industry certification preferred
• 3 years of experience in life claims administration and adjudication
• Understanding of claim treaty provisions, adjudication thresholds, and regulatory compliance.
• Strong analytical and decision-making skills with attention to detail and accuracy.
• Strong problem-solving skills and the ability to navigate and resolve complex issues.
• Strong analytical and organizational skills.
• Proficiency in claims systems and reporting tools.
• Ability to work independently and collaboratively across teams.
• Excellent communication and problem-solving skills.

As a leading global reinsurer, SCOR offers its clients a diversified and innovative range of reinsurance and insurance solutions and services to control and manage risk. Applying “The Art & Science of Risk,” SCOR uses its industry-recognized expertise and cutting-edge financial solutions to serve its clients and contribute to the welfare and resilience of society in around 160 countries worldwide.

Working at SCOR means engaging with some of the best minds in the industry – actuaries, data scientists, underwriters, risk modelers, engineers, and many others – as we work together to find solutions to pressing challenges facing societies.

As an international company, our common culture is defined by “The SCOR Way.” Serving both to build momentum that drives the Group forward and as a compass to guide our actions and choices, The SCOR Way is anchored by five core values, reflecting the input of employees at all levels of the Group. We care about clients, people, and societies. We perform with integrity. We act with courage. We encourage open minds. And we thrive through collaboration.

SCOR supports inclusion and the diversity of talents, and all positions are open to people with disabilities.