Group Claims Associate

Horace Mann is seeking a detail-oriented and service-focused Group Claims Associate to join our team. In this role, you will be responsible for supporting the end-to-end processing and administration of Group Life, Disability, and Waiver of Premium claims. You’ll ensure claims are reviewed accurately, processed efficiently, and managed in compliance with company policies and regulatory requirements.

This is an excellent opportunity for an individual looking to grow their career in insurance claims, while building expertise in Group Insurance operations, customer communication, and claims analysis within a supportive, team-oriented environment.

Key Responsibilities

Claims Processing & Administration

• Prepare and organize files for new group claims, ensuring all required documentation is collected and accurate.
• Review, analyze, and process Group Life, Disability, and Waiver of Premium claims according to company policies and applicable regulations.
• Enter claims data accurately into the claims management system and maintain comprehensive, organized claim files.
• Review claim forms and submitted bills for accuracy and completeness, ensuring all required information is obtained.
• Evaluate claims applicability based on contract provisions, discrepancies in submitted information, and potential need for investigation.
• Identify and refer questionable or complex claims to appropriate resources for further review.
• Determine allowable benefits under company guidelines for routine claims and process accordingly.

Customer Service & Communication

• Provide prompt, professional, and courteous service to clients, policyholders, and beneficiaries.
• Communicate effectively with clients and internal departments to gather documentation, clarify claim details, and resolve inquiries.
• Collaborate with underwriting, legal, compliance, and other departments to resolve complex or escalated claims.
• Support the identification and review of potential fraudulent claims, escalating appropriately when necessary.
• Ensure accurate, timely communication throughout the claim lifecycle to deliver a positive and transparent customer experience.

Compliance, Reporting & Continuous Improvement

• Maintain a current understanding of company products, policies, and industry regulations to ensure compliant claims handling.
• Utilize claims management software and analytical tools to streamline processes and enhance accuracy.
• Assist in identifying trends and patterns in claims data to recommend process improvements.
• Support internal reporting, documentation, and process reviews as needed to maintain accuracy and operational efficiency.

Qualifications & Experience

• H.S. Diploma or GED equivalent, required.
• Bachelor’s degree in a related field or equivalent work experience preferred.
• Excellent attention to detail, accuracy, and organizational skills.
• Strong communication and interpersonal abilities for interacting with clients and team members.
• Basic knowledge of insurance products, claims operations, or financial services.
• Proficiency with claims management software and Microsoft Office applications.
• Strong problem-solving and analytical thinking skills with a focus on quality and customer service.
• Normal office environment.
• Periodic travel may be required.

Pay Range:

• $21.00 - $33.00/hr.

Salary is commensurate to experience, location, etc.