Senior Claims Examiner (Allied Healthcare)

Location: Primarily hybrid with in-office attendance at least two days per week for candidates near an office; qualified remote candidates may also be considered. The role can be based in Atlanta, Boston, Chicago, Manhattan, Scottsdale, or West Hartford, United States.

Salary: $95,000–$120,000 per year

Company

hirify.global USA provides commercial insurance products for small and middle-market clients, including professional liability, technology, cyber, media, management liability, and property coverage.

What you will do

• Analyze professional liability exposures and interpret policy language, endorsements, exclusions, limits, retentions, and coverage triggers.
• Investigate claims by reviewing medical records, provider documentation, licensing information, contracts, and applicable standards of care.
• Develop claim action plans covering coverage, liability, damages, litigation strategy, reserves, and resolution opportunities.
• Manage litigated claims through counsel selection, budgeting, expert retention, mediation, settlement conferences, and trial preparation.
• Identify and escalate complex, high-exposure, reputational, regulatory, or excess-involvement matters.
• Collaborate with underwriting, actuarial, risk management, brokers, counsel, experts, insureds, and healthcare organizations on claim trends and risk improvement.

Requirements

• 1–3 years of claims-handling experience in insurance, third-party administration, a law firm, healthcare, or a related industry.
• Basic knowledge of claims investigation, evaluation, coverage analysis, reserve practices, and regulatory requirements.
• Ability to manage a caseload, maintain accurate claim documentation and diaries, and communicate on time with insureds, brokers, counsel, and business partners.
• Ability to review medical records and legal documents, analyze liability and damages, negotiate, and identify matters requiring escalation.
• Bachelor’s degree from an accredited college or university.
• An active adjuster’s license is preferred; required licensing must be obtained within 90 days if applicable.

Nice to have

• Experience with professional liability, allied healthcare, medical malpractice, long-term care, or bodily injury claims.
• Exposure to litigated claims, legal processes, litigation management, and dispute resolution.
• Coursework or experience in insurance, healthcare, legal studies, or risk management.

Culture & Benefits

• Competitive salary and performance-based bonus.
• 401(k) with company matching, health, vision, dental, and FSA plans.
• Paid time off, company holidays, parental leave, and a four-week paid sabbatical after five years.
• Life, short-term disability, and long-term disability coverage.
• Health club reimbursement, Headspace subscription, financial adoption assistance, and medical travel reimbursement.
• Values-driven culture with modern, open office spaces and complimentary drinks.