Description
We are looking for an experienced Sr. Claims Specialist to support insurance follow-up operations in Hinsdale, Illinois. This Long-term Contract position is ideal for someone who is detail oriented and can independently manage complex claim activity, assess supporting evidence, and make sound decisions in fast-paced environments. The role blends traditional claims investigation with the use of AI-enabled tools to strengthen fraud analysis, claim evaluation, and documentation quality.


Responsibilities:

• Oversee an active caseload of claims, maintaining consistent review and follow-up to move files efficiently through investigation and resolution.

• Examine claim records, supporting documents, statements, images, and prior file history to identify key facts, inconsistencies, and potential exposure.

• Determine appropriate claim outcomes by applying policy guidance and evidence, including approvals, denials, or referral for legal ...