Group Claims Examiner

TL;DR

Group Claims Examiner (Group Insurance): Review and manage Life, Disability, and Waiver of Premium claims, ensuring compliance with company policies and regulatory standards with an accent on evaluating waiting periods, verifying providers, and assessing fees and benefits. Focus on conducting investigations, detecting fraud, maintaining accurate data, and collaborating with legal and compliance teams on complex cases.

Remote

$27.64 - $38.03/hr

Company

hirify.global is an insurance provider founded in 1945, serving over 4,100 school districts nationwide with more than $12 billion in assets, focused on protecting educators.

What you will do

• Review and process claims for Short-Term Disability, Long-Term Disability, Waiver of Premium, and Life insurance, approving within authority limits and escalating complex cases.
• Verify documentation, medical providers, and fees; conduct investigations and identify fraud or discrepancies.
• Enter and maintain accurate claims data in management systems and prepare audit-ready files.
• Provide customer service to claimants, employers, and partners; communicate effectively to resolve inquiries.
• Collaborate with legal, compliance, underwriting, and SIU teams on disputed claims.
• Analyze claims data for trends, prepare reports, and support workflow improvements and new tools.

Requirements

• High School Diploma or GED required; Bachelor’s degree in a related field or equivalent experience preferred.
• 2–4 years of experience in group insurance claims processing or related financial services role.
• Strong understanding of insurance policies, claims practices, and regulatory standards.
• Proficiency with claims management systems and Microsoft Office applications.
• Excellent analytical, problem-solving, decision-making, and communication skills; attention to detail in fast-paced environment.
• Commitment to continuous learning and professional development.

Culture & Benefits

• Normal office environment with periodic travel possible.
• Support for educators' financial goals through tailored insurance and financial products.
• EOE commitment to diversity, equity, and inclusion without discrimination.
• Publicly traded company (NYSE: HMN) with nationwide presence.