Adjuster II

Paycom; Elkhorn Precinct (NE); Hybrid; USD 36,000 - 40,000; Full time

Benefits offered by this job

Medical

Health Savings Account

Dental

Vision

Dependent Care FSA

Gym access

Life Insurance

Disability

Paid Holidays

PTO

401(k)

Job summary

Guarantee Trust Life in the Omaha-area (Elkhorn, NE) office is seeking a Medical Claims Adjuster to adjudicate claims based on contract provisions and state guidelines. The role requires strong knowledge of policy language, medical terminology, and benefit administration.

You will work on-site most days with three flexible remote days per month and enjoy half-day Fridays. Candidates should have 2–3 years of claims experience, solid data entry skills, and excellent communication.

Qualifications

• 2–3 years of medical health claim adjusting experience, preferably hospital indemnity claims.
• Experience reading and referencing policy language for benefit administration.
• Experience in preexisting or investigations a plus.
• Basic knowledge of Microsoft Office Word and Excel.
• Strong data entry skills.
• Excellent verbal and written communication.
• Ability to analyze risk.
• Must have good judgment and strong prioritizing and organizational skills.

Responsibilities

• Adjudicate medical claims based on contract provisions and benefits according to state guidelines.
• Understand policy contract language, insurance applications, and medical terminology.
• Collaborate with departments to ensure accurate claim resolution.

Skills

Medical claim adjusting

Policy language interpretation

MS Word & Excel

Data entry

Communication skills

Risk analysis

Judgment & prioritization

Tools

Microsoft Office

Job description

Job Details

Job Location: Elkhorn, NE 68022, Company Overview

Where You’ll Work

This position is required to work on-site in our Omaha-area (Elkhorn, NE) office most days. Everyone receives 3 flexible remote days per month. And, we offer half-day Fridays – every Friday!

Role Overview

The primary responsibilities are to adjudicate claims based on variable contract provisions and benefits according to state guidelines. The person in this position must understand policy contract language, insurance applications, medical terminology, and medical aspects.

Qualifications

• 2-3 years of medical health claim adjusting experience, preferably hospital indemnity claims
• Experience reading and referencing policy language for benefit administration
• Experience in preexisting or investigations a plus
• Basic knowledge of Microsoft Office Word and Excel
• Strong data entry skills
• Excellent verbal and written communication
• Ability to analyze risk
• Must have good judgment and strong prioritizing and organizational skills

Compensation & Benefits

• Medical
• Health Savings Account (including employer contribution)
• Dental
• Vision
• Dependent Care FSA
• Complimentary access to the buildings gym and fitness amenities
• Basic Life Insurance (full premium paid by employer)
• Voluntary Employee, Spouse and Child Life Insurance
• Short-Term and Long-Term Disability
• Paid Holidays
• Paid time off including vacation, personal days, sick time and Summer / Flex Fridays
• 401(k), 401(k) Match and Profit-Sharing Retirement Plan

The pay range for this role is $26-$29 / hour. The pay range provided is not a guarantee of compensation. The range reflects potential pay for the job grade for this role at the time of this posting. Compensation will depend on several factors such as specific competencies, relevant education and experience, qualifications, and industry certifications. Compensation ranges are subject to change and may be higher or lower than the range described above.

Stay Connected with GTL

We invite you to learn more about Guarantee Trust Life by visiting:

Website

LinkedIn

EOE m/f/d/v