Claims Examiner – Partner Programs (Equity Eligible)

Hippo; Austin, Dallas, Morristown (TX, TX, NJ); On-site; USD 85,000 - 120,000; Full time

Benefits offered by this job

Healthy Benefits

Equity

Training & Growth

Flexible Time Off

Parental Leave

Hippo Habitat

Job summary

Hippo is seeking a Claims Examiner – Partner Programs to review and approve claims beyond TPAs' authority, analyze coverage, and coordinate with internal and external stakeholders. The role emphasizes accurate reserves, timely payments, and guidance to TPAs for proper investigations.

You will work with TPAs, underwriters, and reinsurers, ensuring regulatory compliance and clear communication while supporting ongoing program improvements and stakeholder reporting.

Qualifications

• 2–5 years of claims handling experience in property, casualty, or specialty lines.
• Basic understanding of insurance coverage principles and policy interpretation.
• Experience investigating and resolving claims, including exposure analysis and reserving.
• Strong written and verbal communication skills.
• Organizational skills with the ability to manage a caseload effectively.
• Ability to work collaboratively with internal teams and external partners.

Responsibilities

• Review claims submitted by TPAs and authorize reserves and payments where those amounts exceed the TPA’s authority
• Provide guidance to TPAs to ensure proper investigation and timely, equitable disposition of claims, including retention of experts and/or attorneys where needed
• Assist TPA with coverage analysis, seeking underwriting assistance where appropriate
• Review and approve reservation of rights and coverage denial letters to ensure accuracy and consistency in coverage analysis
• Review claims to ensure appropriate reserve levels and that changes are made on a timely basis
• Refer claims more than authority to supervisor
• Prepare notifications to underwriters and reinsurers for large or contentious claims
• Review and approve TPA funding requests within authority
• Participate in claim file audits to monitor TPA performance
• Assist with preparation of reports for underwriting, agents, insureds or state agencies as needed
• Provide clear and professional communication to TPAs/Claim Administrators, brokers, and program partners
• Issue timely claim correspondence, status updates, and regulatory notices
• Participate in claim reviews and provide updates to management as requested
• Escalate complex coverage or high-exposure matters to senior leadership
• Ensure claim handling complies with regulatory requirements and internal guidelines
• Support data calls, audits, and reporting requests
• Assist with reinsurer reporting requirements when applicable
• Participate in training programs and technical development opportunities
• Seek feedback and coaching to continuously improve claim handling skills
• Contribute to team collaboration and knowledge sharing

Skills

Claims handling

Insurance knowledge

Communication

Organization

Team collaboration

Tools

MS Office

Job description

Hippo is seeking a Claims Examiner – Partner Programs to review and approve claims beyond TPAs' authority, analyze coverage, and coordinate with internal and external stakeholders. The role emphasizes accurate reserves, timely payments, and guidance to TPAs for proper investigations.

You will work with TPAs, underwriters, and reinsurers, ensuring regulatory compliance and clear communication while supporting ongoing program improvements and stakeholder reporting.