Accident, Critical Illness and Hospital Indemnity Benefit Claim Technician

Join our team as a Benefit Claims Technician, where you’ll play a vital role in evaluating and adjudicating Group Claims (including Accident, Critical Illness and Hospital). This position involves end-to-end claims processing—from initial notification through the duration of the claim—ensuring timely, accurate decisions while delivering an exceptional customer experience. The ideal candidate will possess strong analytical, critical thinking, and communication skills, and will be responsible for interpreting medical and contractual information, detecting potential fraud, and adhering to regulatory requirements. This role directly contributes to the financial performance and customer retention goals of our organization.

Our next training class is in January!! The training hours will be 8:00am – 4:30pm CST, for 6 weeks. Following training, the shift will move to 9:00am – 5:30pm CST.

WHAT WE CAN OFFER YOU:

• Hourly Wage: $24.50, plus annual bonus opportunity.
• 401(k) plan with a 2% company contribution and 6% company match.
• Work-life balance with vacation, personal time and paid holidays. See our benefits and perks page for details.
• Applicants for this position must not now, nor at any point in the future, require sponsorship for employment.

WHAT YOU'LL DO:

• Independently evaluates claims by gathering and analyzing relevant information to make sound, well-documented decisions based on policy provisions and procedures.
• Maintains professional communication and builds strong relationships with claimants, employers, brokers, vendors, and internal teams (e.g., legal, underwriting).
• Ensures accurate financial determinations and eligibility assessments using salary data, contract terms, and medical/vocational documentation.
• Provides timely updates and clear written explanations to claimants and policyholders, maintaining high standards of customer service and compliance with ERISA and other regulations.
• Stays current with industry trends, legal requirements, and internal process changes to ensure accurate and efficient claims handling.

WHAT YOU’LL BRING:

• Experience working with insurance claims with a preferred focus on Accident, Critical Illness and Hospital Indemnity products
• Demonstrated ability to analyze complex insurance and medical data, apply regulatory knowledge to claims decisions, and communicate effectively with professionalism and empathy.
• Proficient in calculating benefits from basic to complex levels using policy provisions and supporting documentation.
• Highly organized with strong attention to detail, able to meet deadlines, manage priorities, and transition toward independent decision-making.
• Adaptable to change, with the ability to handle difficult situations calmly, escalate issues appropriately, and work effectively with various systems and tools.
• You promote a collaborative culture, value different ideas and opinions, and listen courageously, remaining curious in all that you do.
• Able to work remotely with access to a high-speed internet connection and located in the United States.

PREFERRED:

• Claims processing skills/experience

We value unique experience, skills, and passion for innovation. If your experience aligns with the listed requirements, please apply!

If you have questions about your application or the hiring process, email our Talent Acquisition area at . Please allow at least one week from time of applying if you are checking on the status.

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Originally posted on Himalayas