Claim Examiner - Life

Physicians Mutual; Omaha (NE); On-site; USD 50,000 - 65,000; Full time

Job summary

Physicians Mutual in Omaha, NE is seeking a Life Claims Examiner to evaluate life insurance claims by reviewing policy provisions, death certificates, and documentation. You will need strong communication and organizational skills, and the role involves ensuring timely decisions in compliance with state regulations.

The ideal candidate has a high school diploma, 1-2 years of related experience, and the ability to handle complex situations effectively. This position emphasizes thorough investigation and problem-solving abilities.

Qualifications

• Strong communication skills are necessary to correspond with beneficiaries and other parties.
• Ability to handle complex claim situations and conduct thorough investigations.
• Basic math skills required for calculating benefits and interest.

Responsibilities

• Communicate with beneficiaries, providers, and involved parties.
• Analyze life insurance policy benefits, death certificates, and related correspondence.
• Evaluate information and follow regulations to make proper payment or reject decisions.

Skills

Strong communication skills

Problem solving

Decision-making

Organizational skills

Basic math skills

Ability to read policy contracts

Education

High school diploma or equivalent

Job description

Overview

Physicians Mutual is seeking a Life Claims Examiner to join our Claims team. In this role, you will review and evaluate life insurance claims by analyzing policy provisions, death certificates, and supporting documentation to determine accurate claim outcomes. You’ll communicate with beneficiaries and other parties, ensure compliance with state regulations, and make timely payment or denial decisions.

Responsibilities

• Responsible for communicating with beneficiaries, providers and other involved parties.
• Analyzing life insurance policy benefits and provisions, death certificates and other related correspondence.
• Evaluates all information received and follows state regulations to make proper payment or reject decision.

Qualifications

• High school diploma or equivalent.
• Must demonstrate strong communication skills.
• Ability to read policy contracts.
• Ability to handle complex claim situations.
• Ability to operate a PC and all applicable programs and applications.
• Must possess problem solving, decision‑making, and organizational skills.
• Ability to function effectively in a production environment with high quality work.
• Ability to learn quickly and adapt to new insurance coverages, procedures and state guidelines.
• Basic math needed to calculate benefits and interest.
• Above average written and verbal communication skills are necessary to effectively correspond with Policyowners and other interested parties.
• Ability to assess situations and apply learned concepts in complicated claim scenarios.
• Conduct a thorough investigation of correspondence received and information online, as necessary, to resolve claims.
• Diligent in managing project details.
• Prefer a minimum of 1‑2 years of previous life insurance or related experience.