Claims Examiner

Job description

Horace Mann is seeking a detail-oriented and experienced Claims Examiner to join our team in a hybrid work environment in Plano, TX office. This role is responsible for setting up and adjudicating claims efficiently while providing exceptional quality service to build customer satisfaction and loyalty. The ideal candidate will have experience in life/health claims, strong organizational skills, and the ability to communicate effectively with policyholders, healthcare providers, and internal teams. If you thrive in a fast-paced environment, have a keen eye for detail, and enjoy making a meaningful impact, this is the perfect opportunity for you! This is not a fully remote position, and you must be able to commute to the Plano office. Responsibilities: Requirements: - Link and set up Substantive, Group, Wellness, and Physician Consult claims in the work distribution and policy administration system. - Evaluate submitted claims by reviewing policy provisions and applicable laws to accurately adjudicate claims. - Provide claimants with necessary forms, instructions, and assistance to ensure a smooth claims process. - Draft and send letters requesting medical or other necessary informat...