Claims Examiner – Spinnaker

Claims Examiner – Spinnaker

Job Title: Claims Examiner – Partner Programs

Location: Austin, TX / Dallas, TX / Bedminster, NJ / San Jose, CA

Reports To: Claims Program Manager or Claims Manager

About Hippo

Hippo exists to protect the joy of homeownership. We believe that insurance should protect the things you treasure through an intuitive, modern experience. We provide tailored insurance coverage and preventative maintenance plans that keep you protected throughout your homeowner journey. We’ll also help you find coverage for everything life brings—from auto to flood—reimagining how you care for your home.

About The Role:

The Claims Examiner – Partner Programs is responsible for the timely and accurate review and approval of claims exceeding the TPA’s/Claim Administrator’s authority, in accordance with company guidelines, regulatory requirements, and best claim practices. This role analyzes coverage, authority requests for reserves and payment on claims through resolution, including communication with internal and external stakeholders.

What You’ll Do:

Claim Handling & Investigation

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

Communication & Service

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

Compliance & Reporting

Ensure claim handling complies with regulatory requirements and internal guidelines

Maintain proper documentation in claim management systems

Support data calls, audits, and reporting requests

Assist with reinsurer reporting requirements when applicable

Professional Development

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

What You Bring:

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

Proficiency in Microsoft Office applications (Excel, Word, Outlook)

Nice to Have:

Experience working with TPAs or program business

Exposure to litigated claims

Professional designations in progress or interest in pursuing (AIC, ARM, CPCU, etc.)

Benefits and Perks

Hippo treats its team members with the same level of dedication and care as we do our customers, which is why we’re fortunate to provide all of our Hippos with:

Healthy Hippos Benefits - Multiple medical plans to choose from and 100% employer covered dental & vision plans for our team members and their families. We also offer a 401(k)-retirement plan, short & long-term disability, employer-paid life insurance, Flexible Spending Accounts (FSA) for health and dependent care, and an Employee Assistance Program (EAP)

Equity - This position is eligible for equity compensation

Training and Career Growth - Training and internal career growth opportunities

Flexible Time Off - You know when and how you should recharge

Little Hippos Program - We offer 12 weeks of parental leave for primary and secondary caregivers

Hippo Habitat - Snacks and drinks available for onsite employees

The Morristown, NJ base pay range for this role is $85,000 - $120,000. Exact compensation may vary based on several job-related factors that are unique to each candidate, including but not limited to: skill set, experience, education/training, location, business needs and market demands.

Hippo is an equal opportunity employer, and we are committed to building a team culture that celebrates diversity and inclusion.

Hippo’s applicants are considered solely based on their qualifications, without regard to an applicant’s disability or need for accommodation. Any Hippo applicant who requires reasonable accommodations during the application process should contact the Hippo’s People Team to make the need for an accommodation known.

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