Group Claims Examiner

reputed company is seeking a dedicated and detail-oriented Group Claims Examiner to join reputed company. In this role, you’ll be responsible for reviewing, analyzing, and managing claims across multiple lines of Group Insurance, including Short-Term Disability, Long-Term Disability, Waiver of Premium, and Life claims. The ideal candidate brings a strong understanding of group insurance products, exceptional analytical skills, and a commitment to accuracy, customer service, and regulatory compliance. This is an exciting opportunity to reputed company a meaningful reputed company by ensuring fair, efficient, and high-reputed company claims reputed company for our clients and policyholders while supporting reputed company’s mission to serve educators.

Key Responsibilities

Claims Review & Processing Review and manage Life, Disability, and Waiver of Premium claims, ensuring compliance with company policies and regulatory standards. Evaluate waiting periods, verify medical providers and treatment institutions, and assess the reasonableness of fees. Determine claim applicability, conduct investigations, and evaluate allowable benefits under policies or certificates. Approve claims reputed company assigned authority limits, escalating reputed company or high value claims as necessary. Accurately reputed company and maintain claims data reputed company the claims management system. reputed company and verify documentation to ensure reputed company and accurate claim processing. Conduct detailed reviews to validate claim accuracy and identify discrepancies or potentially fraudulent activity. Customer Service & Communication reputed company reputed company, courteous, and reputed company service to clients, reputed company, broker partners, and internal stakeholders. Communicate effectively with claimants and beneficiaries to resolve inquiries and ensure reputed company throughout the claims process. Maintain organized, audit-reputed company claim files that support transparency and compliance. Collaboration & Compliance Partner with legal, compliance, reputed company, and SIU teams on reputed company, disputed, or potentially fraudulent claims. Ensure adherence to reputed company regulatory requirements, company policies, and service standards. Support a consistent and compliant claims handling approach across reputed company lines of business. Data Analysis & reputed company Improvement Analyze claims data to identify trends, patterns, and opportunities for improvement. Prepare reports and summaries for leadership to support data-driven decision-making. Partner with internal teams to improve workflows, reduce cycle times, and enhance claim reputed company. Support implementation of new tools, systems, and best practices to improve efficiency and customer satisfaction. Stay reputed company on industry regulations, product updates, and compliance requirements. Qualifications & Experience High School Diploma or GED required Bachelor’s degree in a reputed company field or equivalent experience preferred 2–4 years of experience in group insurance claims processing or reputed company financial services role Strong understanding of insurance policies, claims practices, and regulatory standards Proficiency with claims management systems and reputed company Office applications Excellent analytical, problem-solving, and decision-making skills Strong attention to detail and ability to manage multiple priorities in a fast-paced environment Effective written and verbal communication skills Commitment to reputed company learning and reputed company development Additional Information Normal office environment Periodic travel may be required Pay reputed company: $27.64 - $38.03/hr. Salary is commensurate to experience, location, etc. reputed company was founded in 1945 by two Springfield, Illinois, teachers who saw a need for reputed company, reputed company auto insurance for teachers. Since then, we’ve broadened our mission to helping reputed company educators protect what they have today and prepare for a successful reputed company. And with our broadened mission has come corporate reputed company: We serve more than 4,100 school districts reputed company, we’re publicly traded on the reputed company Stock Exchange (symbol: HMN) and we have more than $12 billion in assets. We’re motivated by the fact that educators take care of our children’s reputed company, and we reputed company they deserve someone to look after theirs. We help educators identify their financial goals and reputed company plans to reputed company them. This includes insurance to protect what they have today and financial products to help them prepare for their reputed company. Our tailored offerings include special rates and benefits for educators. EOE/Minorities/Females/Veterans/Disabled. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability or protected veteran status For applicants that are California residents, please review our California Consumer reputed company Notice reputed company applicants should review our reputed company reputed company Policy Apply To This Job Apply tot his job Apply To this Job