Appeals Case Manager II (Group Disability and Life Claims)

Location: Remote - United States; mobile position with potential travel to Guardian offices and occasional travel of 0–10%.

Salary: $58,620–$96,300 per year.

Company

hirify.global is a mutual insurance and financial services company providing life, health, disability, and wealth products to individuals and employers.

What you will do

• Adjudicate assigned Group Life, Short-Term Disability, Long-Term Disability, and Life Waiver of Premium appeals.
• Investigate disputed claims, interpret plan provisions, and provide timely, compliant appeal resolutions.
• Evaluate medical, financial, and other claim information in consultation with clinical and vocational professionals.
• Identify legal and compliance issues requiring additional research and facilitate their resolution.
• Provide proactive service to internal and external customers while sharing insights with claims colleagues.
• Maintain knowledge of ERISA and Department of Labor guidelines and independently prioritize work.

Requirements

• High school diploma or GED required.
• At least five years of Group Disability and/or Life Claims experience.
• Strong verbal and written communication, problem-solving, analytical, mathematical, and research skills.
• Ability to manage multiple priorities while complying with applicable regulatory requirements.
• Must be legally authorized to work in the United States without current or future employer sponsorship.
• Ability to work remotely and travel occasionally to Guardian offices as determined by the People Leader.

Nice to have

• At least three years of experience handling appeals and/or complex claims.
• Bachelor’s degree or an equivalent combination of education and professional experience.

Culture & Benefits

• Full-time employment with medical, dental, supplemental health, life, and vision coverage.
• 401(k) plan with company match, life and disability insurance, tuition assistance, paid parental leave, and backup family care.
• Flexible time off, dress code, and work location policies.
• Skill-building, leadership development, philanthropic opportunities, and employee resource groups.
• Inclusive work environments focused on collaboration, ethical standards, and professional development.