Claims and Implementation Specialist (Insurance)

TL;DR

Claims and Implementation Specialist (Insurance): Coordinating the post-sale implementation and onboarding of self-funded benefit programs with an accent on stop loss, captive, and level-funded solutions. Focus on managing project timelines, facilitating stakeholder communication, and ensuring operational consistency through claims monitoring and carrier reporting.

Location: Must be based in the United States

Salary: $65,000–$70,000 per year

Company

hirify.global is a people-focused organization providing comprehensive insurance and employee benefit solutions to over 100,000 employers.

What you will do

• Manage post-sale implementation of stop loss, captive, and self-funded benefit programs.
• Develop and oversee implementation timelines and project plans.
• Coordinate onboarding activities between employers, consultants, TPAs, and stop loss carriers.
• Facilitate implementation meetings and provide status updates to stakeholders.
• Monitor claims, track reimbursements, and handle carrier reporting activities.
• Maintain company databases and ensure accurate documentation and contract submission.

Requirements

• Must be based in the United States
• 2–5 years of experience in employee benefits, health insurance, or TPA operations.
• Strong project management and organizational skills.
• Intermediate to advanced Microsoft Excel proficiency.
• Current Life & Health Insurance License or ability to obtain within 90 days of hire.
• Excellent verbal, written, and presentation communication skills.

Nice to have

• Experience with self-funded health plans and captive programs.
• Familiarity with stop loss reimbursement processes.
• Experience managing client implementations or onboarding projects.

Culture & Benefits

• Comprehensive health, wellbeing, and retirement financial benefits.
• Paid time off and overtime pay for non-exempt employees.
• Robust learning and development programs.
• Reimbursement of job-related expenses.
• Commitment to diversity, equity, and inclusion.