TPA Examiner
Listed on 2026-10-23
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Insurance
Insurance Claims, Insurance Agent & Advisor, Insurance Analyst, Risk Manager/Analyst
SI Advisers “A Custard Company” delivers customized solutions to clients while maintaining industry-leading standards in every aspect of operations. The organization specializes in field claims adjusting, subrogation recovery, and third‑party administration (TPA) services, emphasizing accuracy, responsiveness, and client satisfaction. SI Advisers supports clients with comprehensive claims and TPA capabilities designed to streamline processes and improve outcomes. The team is available 24/7/365, ensuring continuous service and support.
This commitment to reliability and expertise creates a dynamic environment for professionals seeking growth in claims and TPA administration.
This is a full‑time remote role for a TPA Examiner at SI Advisers “A Custard Company.” The TPA Examiner will review, analyze, and adjudicate claims in accordance with policy terms, regulatory requirements, and client guidelines. Responsibilities include verifying coverage, assessing liability, determining appropriate payments, and documenting claim decisions clearly and accurately in the system. The role involves regular communication with policyholders, claimants, agents, and other stakeholders to gather information, provide updates, and resolve inquiries.
The TPA Examiner will collaborate with internal teams to ensure timely claim handling, elevate complex cases when needed, and contribute to process improvement and quality assurance initiatives.
- Experience in claims examination, TPA administration, or insurance adjusting, with a strong understanding of policy language and claim processes.
- Proficiency in data entry, documentation, and claims management systems, with attention to accuracy and compliance.
- Strong analytical and problem‑solving skills to evaluate claim information, assess liability, and make sound decisions.
- Clear written and verbal communication skills for interacting with clients, claimants, and internal stakeholders.
- Ability to work independently in a remote setting, manage time effectively, and handle multiple claims and deadlines.
- Familiarity with relevant insurance regulations and industry standards; prior experience in field claims adjusting or subrogation is a plus.
- AMF licensed
- Commitment to ethical conduct, confidentiality, and delivering high‑quality service to clients and claimants.
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