Carrier Senior Claims Oversight Analyst

Established in 2021, Independence Pet Holdings is a corporate holding company that manages a diverse and broad portfolio of modern pet health brands and services, including insurance, pet education, lost recovery services, and more throughout North America.

We believe pet insurance is more than a financial product and build solutions to simplify the pet parenting journey and help improve the well-being of pets. As a leading authority in the pet category, we operate with a full stack of resources, capital, and services to support pet parents. Our multi-brand and omni-channel approach include our own insurance carrier, insurance brands and partner brands. 

The Senior Carrier Operations Claims Analyst (Carrier Operations Quality Claims Senior Analyst) provides oversight of delegated claims operations and serves as a subject matter expert for complex claims, coverage interpretation, appeals, and escalated claim matters. This role partners with internal stakeholders and third-party administrators to ensure claims are handled consistently, compliantly, and in accordance with carrier guidelines.

• Review and provide recommendations on high-dollar, complex, and over-authority claims.
• Evaluate coverage determinations, appeals, exceptions, and other escalated claim matters.
• Identify claim trends, operational risks, and opportunities for improvement across administrator partners.

• Support audits, market conduct examinations, regulatory inquiries, and corrective action initiatives.
• Monitor administrator compliance with carrier requirements, policies, and regulations.
• Assist with fraud-related investigations, reporting, and risk mitigation activities.

• Analyze claims data, audits, and operational metrics to improve performance and outcomes.
• Review administrator workflows, procedures, and controls for effectiveness and compliance.
• Partner with stakeholders to implement process improvements and corrective action plans.

• Develop and maintain claims guidelines, governance standards, and operational procedures.
• Support ongoing enhancements to claims oversight and governance programs.
• Communicate policy updates, claims guidance, and operational requirements to stakeholders.

• Serve as a subject matter expert for claims oversight and delegated claims administration.
• Provide guidance, training, and support to team members and business partners.
• Participate in projects and initiatives that strengthen carrier operations and claims governance.

• 5+ years of insurance claims, claims operations, compliance, quality, or related experience.
• Strong knowledge of claims handling, coverage interpretation, and regulatory requirements.
• Excellent analytical, problem-solving, communication, and stakeholder management skills.

• Experience working with TPAs, delegated authority programs, or carrier oversight functions.
• Experience supporting audits, compliance initiatives, fraud investigations, or process improvements.
• Bachelor’s degree in Business, Insurance, Risk Management, or a related field.

• Claims Oversight & Governance
• Regulatory Compliance & Risk Management
• Coverage Analysis & Problem Solving
• Process Improvement & Operational Excellence
• Communication & Business Partnership