Claims Department Manager (Health Insurance)

Location: Clearwater, Florida, United States; work may be performed in a standard office or remote environment, as applicable.

Company

hirify.global is an independent distributor of life, health, and wealth insurance products with a strong insurtech focus, serving independent agents and clients nationwide.

What you will do

• Lead day-to-day claims department operations, including supervisors, support functions, workflows, priorities, and resource allocation.
• Monitor payment accuracy, quality, productivity, inventory, turnaround times, and service-level performance; implement corrective action plans when standards are not met.
• Prepare, analyze, and distribute operational, client, regulatory, and management reports.
• Maintain policies, procedures, workflows, operational controls, claims systems, interfaces, integrations, and related dependencies.
• Lead UAT, implementation activities, operational readiness reviews, system enhancements, process changes, client conversions, and other strategic initiatives.
• Train, coach, mentor, and evaluate staff while partnering with leadership, Human Resources, clients, vendors, and technology teams on operational and personnel matters.

Requirements

• Bachelor’s degree in Healthcare Administration, Business Administration, Insurance, or a related field preferred; equivalent education and relevant experience may be considered.
• At least five years of proven experience in the health insurance industry with progressively responsible experience in health claims operations.
• Leadership experience managing supervisors and multiple operational teams.
• Familiarity with medical terminology, procedure codes, diagnosis codes, and healthcare claims processing practices preferred.
• Proficiency with Microsoft Office applications, including Word and Excel.
• Experience with claims administration systems, workflow management tools, and related operational technologies preferred.
• Ability to interpret policy provisions, benefits, eligibility requirements, and claims payment methodologies.
• Strong analytical, problem-solving, decision-making, verbal, written, and interpersonal communication skills.
• Ability to manage competing priorities, meet deadlines, maintain a dependable work schedule, meet attendance expectations, and exercise sound judgment with confidentiality and professionalism.
• Occasional travel may be required for training, meetings, or business-related activities.

Culture & Benefits

• Family-like work environment focused on employee support and professional growth.
• Hyper-growth company with professional development and career advancement opportunities.
• Competitive compensation package and benefits for employees and their families.
• Work may be performed in a standard office or remote environment, as applicable.