Senior Claims Examiner (Medical & Healthcare)

TL;DR

Senior Claims Examiner (Medical & Healthcare): Managing moderate to high complexity medical malpractice and healthcare negligence claims with an accent on coverage analysis, liability assessment, and litigation management. Focus on resolving complex disputes, directing defense strategies, and ensuring accurate reserve setting within authority.

Location: Must be based in Red Bank, NJ (Onsite)

Salary: $73,600 - $107,250

Company

hirify.global Group is a Fortune 500 holding company specializing in insurance, reinsurance, and specialist advisory services with a global presence.

What you will do

• Analyze coverage and draft position letters for healthcare malpractice and negligence claims.
• Conduct and coordinate investigations into loss facts and extent of damages.
• Manage litigated and non-litigated bodily injury claims up to $450,000.
• Represent the company in mediations and monitor trials as required.
• Provide technical guidance and training to other team members.
• Control expenses by directing defense attorneys, independent adjusters, and forensic experts.

Requirements

• Minimum 7-15 years of claims handling experience in insurance.
• Must have or be eligible to receive a claims adjuster license.
• US Work Authorization required (no visa sponsorship).
• Bachelor’s degree or equivalent work experience.
• Advanced expertise in complex claims topics and policy interpretation.
• Strong negotiation, mediation, and trial monitoring experience.

Nice to have

• JD, advanced degree, or focused technical degree.
• Industry designations such as INS, IEA, AIC, ARM, SCLA, or CPCU.
• Participation in industry training programs like CLM Claim College or FDCC.

Culture & Benefits

• Comprehensive health, dental, and vision insurance plans.
• 401(k) retirement plan with employer match.
• Employee Stock Purchase Plan.
• Paid Time Off (PTO) and corporate holidays.
• Parental leave and disability insurance options.