[Hiring] Claims Examiner @Harris Computer

Role Description

As a Claims Analyst specializing in Accident, Critical Illness, Short-Term Disability, and Hospital Indemnity lines of business, you will be responsible for accurately assessing and processing claims related to these insurance products. Your role will involve:

• Investigating claims
• Verifying policy coverage
• Determining liability
• Ensuring compliance with regulatory requirements

Strong analytical skills, attention to detail, and empathy are essential for this position as you will interact with claimants, healthcare providers, and other stakeholders to facilitate timely and fair claim settlements.

Qualifications

• Bachelor's degree in business administration, insurance, healthcare management, or a related field (or equivalent work experience)
• Prior experience in claims processing, preferably in Accident, Critical Illness, LTC, and/or Hospital Indemnity insurance
• Knowledge of insurance principles, policies, and practices related to accident, critical illness, LTC, and hospital indemnity lines of business
• Strong analytical and problem-solving skills with the ability to interpret complex documents and policies
• Excellent communication skills, both verbal and written, with a customer-focused approach
• Proficiency in using claims management software and Microsoft Office Suite (Excel, Word, Outlook)

Requirements

• ACS and/or ALHC Designation
• Experience with medical terminology and healthcare billing practices
• Understanding of regulatory requirements governing claims processing in the insurance industry

Attributes

• Demonstrated strong punctuality and attendance practices
• Detail-oriented with a commitment to accuracy and thoroughness
• Ability to work effectively in a team environment and independently when necessary
• Strong organizational skills with the ability to prioritize and manage multiple tasks
• Adaptable to changing priorities and comfortable working in a fast-paced environment

Work Environment

• Remote work environment role with regular business hours (9:00am – 6:00pm Eastern)
• Occasional overtime or weekend work may be required during peak periods or to meet deadlines
• Opportunities for professional development and career advancement within the claims department or broader insurance organization
• The candidate must possess a curiosity and willingness to actively adopt and leverage emerging AI tools to improve workflows, solve problems, and drive efficiency
• Comfortable using a range of AI-enabled tools (such as copilots, chat-based AI, and automation solutions) as part of everyday work