Claims Examiner - Commercial GL (Healthcare)

Location: Atlanta, Georgia, U.S.; hybrid and remote options indicated. Applicants must be authorized to work for any employer in the U.S.

Company

hirify.global provides specialty insurance services with opportunities for professional development and advancement.

What you will do

• Handle Commercial Healthcare Claims across the U.S., including coverage, investigation, liability, damages, evaluation, and resolution.
• Oversee primary and excess casualty claim portfolios, including portfolios managed by third-party administrators.
• Select, instruct, and manage third-party vendors while controlling allocated loss adjustment expenses.
• Gather and analyze claim information, establish reserves, identify settlement issues, and manage exposure within authority levels.
• Resolve complex and high-exposure claims, including substantial involvement in mediation negotiations and occasional attendance at trials.
• Prepare required reports, collaborate with underwriting on claim trends, and maintain communication with insureds, agents, brokers, and external customers.

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, policy language and coverages applicable to specialty healthcare claims, and medical terminology.
• Strong negotiation, communication, writing, organization, problem-solving, and independent work skills.
• Must have U.S. work authorization; visa sponsorship is not available now or in the future.

Nice to have

• Background in U.S. healthcare professional or general liability claims.
• Experience as a healthcare professional or medical malpractice attorney.
• Experience handling reinsurance claims.
• Multi-state claims adjuster licensure.

Culture & Benefits

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