Claims Examiner - Commercial Healthcare (Healthcare Claims)

Location: Dallas, Texas, United States; hybrid/remote arrangement indicated. Occasional domestic travel may be required for meetings, mediations, and trials.

Company

hirify.global provides specialty insurance products and manages commercial healthcare and casualty claims.

What you will do

• Handle commercial healthcare claims across the United States, including coverage, investigation, liability, damages, evaluation, reserves, and resolution.
• Manage primary casualty claim portfolios and oversee excess casualty claims handled by third-party administrators.
• Select, instruct, and manage vendors while controlling allocated loss adjustment expenses.
• Resolve complex and high-exposure claims, participate in mediation negotiations, and identify settlement issues within assigned authority.
• Follow panel counsel and litigation management guidelines and complete large-loss and other required reports accurately and on time.
• Work with insureds, agents, brokers, external customers, underwriting, TPAs, and legal counsel to address questions, claim trends, and claim-related issues.

Requirements

• College degree or equivalent experience.
• At least 3 years of claims adjusting or legal experience, including experience with primary and excess claims.
• Claims adjuster license in the home state; multi-state licensure is preferred.
• Knowledge of U.S. state and federal laws, specialty healthcare policy language and coverage, and medical terminology.
• Strong negotiation, communication, writing, organization, independent work, teamwork, and problem-solving skills.
• Must be authorized to work for any employer in the United States; visa sponsorship is not available now or in the future.

Nice to have

• Background in U.S. healthcare professional or general liability claims.
• Experience handling reinsurance.
• Previous employment as a healthcare professional or medical malpractice attorney.

Culture & Benefits

• Competitive salary with professional development and advancement opportunities.
• Medical, dental, vision, and life insurance.
• Short- and long-term disability coverage.
• Company-matched 401(k) plan, with a 100% match on a 6% contribution.
• Employee Assistance Plan, Health Savings Account, Flexible Spending Account, Health Reimbursement Account, and wellness program.